MEDICARE: DOCTORS URGENT CARE OF LUTZ LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1760118731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS URGENT CARE OF LUTZ LLC

Provider Business Mailing Address
First Line	:	8416 RIDGE RD UNIT 2
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-4916
Country	:	US
Telephone Number	:	813-388-5922
Fax Number	:

Provider Business Practice Location Address
First Line	:	8416 RIDGE RD UNIT 2
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-4916
Country	:	US
Telephone Number	:	813-388-5922
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AASHISH DESAI
Credential	:	MD
Telephone Number	:	813-388-5922

Provider Enumeration Date	:	08/01/2022
Last Update Date	:	11/15/2022

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