Provider Demographics
NPI:1841704038
Name:SPORTS ER & URGENT CARE CENTER INC
Entity type:Organization
Organization Name:SPORTS ER & URGENT CARE CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HILLEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-654-6049
Mailing Address - Street 1:303 E WOOLBRIGHT RD STE 252
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6010
Mailing Address - Country:US
Mailing Address - Phone:561-654-6049
Mailing Address - Fax:
Practice Address - Street 1:303 E WOOLBRIGHT RD STE 252
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6010
Practice Address - Country:US
Practice Address - Phone:561-654-6049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty