Provider Demographics
NPI:1215150396
Name:LAKEWOOD RANCH URGENT CARE P A
Entity type:Organization
Organization Name:LAKEWOOD RANCH URGENT CARE P A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLKENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-524-0444
Mailing Address - Street 1:7322 MANATEE AVE W # 108
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3441
Mailing Address - Country:US
Mailing Address - Phone:941-447-5854
Mailing Address - Fax:
Practice Address - Street 1:3924 9TH AVE
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205
Practice Address - Country:US
Practice Address - Phone:941-447-5854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1215150396OtherNPI