Provider Demographics
NPI:1003288440
Name:PARAMOUNT URGENT CARE INC
Entity Type:Organization
Organization Name:PARAMOUNT URGENT CARE INC
Other - Org Name:PARAMOUNT URGENT CARE LADY LAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTERLING
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:352-674-9218
Mailing Address - Street 1:805 E COUNTY ROAD 466
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-4205
Mailing Address - Country:US
Mailing Address - Phone:352-674-9218
Mailing Address - Fax:352-259-6069
Practice Address - Street 1:805 E COUNTY ROAD 466
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-4205
Practice Address - Country:US
Practice Address - Phone:352-674-9218
Practice Address - Fax:352-259-6069
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARAMOUNT URGENT CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104065261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care