Provider Demographics
NPI:1316237902
Name:URGENT CARE AND SURGERY CENTER OF FORT LAUDERDALE, INC
Entity type:Organization
Organization Name:URGENT CARE AND SURGERY CENTER OF FORT LAUDERDALE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:ALMONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-493-8875
Mailing Address - Street 1:2040 NE 49TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4524
Mailing Address - Country:US
Mailing Address - Phone:954-493-8875
Mailing Address - Fax:954-493-8876
Practice Address - Street 1:2040 NE 49TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4524
Practice Address - Country:US
Practice Address - Phone:954-493-8875
Practice Address - Fax:954-493-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty