Provider Demographics
NPI:1396997532
Name:LAKEWOOD RANCH URGENT CARE, PA
Entity type:Organization
Organization Name:LAKEWOOD RANCH URGENT CARE, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:FOLKENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-447-5854
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
Mailing Address - Country:US
Mailing Address - Phone:941-447-5854
Mailing Address - Fax:
Practice Address - Street 1:4647 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3849
Practice Address - Country:US
Practice Address - Phone:941-745-5999
Practice Address - Fax:941-749-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care