Provider Demographics
NPI:1124083282
Name:URGENT CARE CENTER OF GAINESVILLE
Entity type:Organization
Organization Name:URGENT CARE CENTER OF GAINESVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:V
Authorized Official - Last Name:PAMINTUAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-371-1777
Mailing Address - Street 1:3925 NW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4565
Mailing Address - Country:US
Mailing Address - Phone:352-371-1777
Mailing Address - Fax:352-371-0298
Practice Address - Street 1:3925 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4565
Practice Address - Country:US
Practice Address - Phone:352-371-1777
Practice Address - Fax:352-371-0298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB903GOtherBLUE CROSS/BLUE SHIELD