Provider Demographics
NPI:1043399074
Name:HCS ACUTE CARE CENTER LLC
Entity Type:Organization
Organization Name:HCS ACUTE CARE CENTER LLC
Other - Org Name:ALOMA URGENT CARE AT NARCOOSSEE ROAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MADHUSUDHAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOMMETI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-215-6370
Mailing Address - Street 1:7252 NARCOOSSEE RD STE 104
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-5550
Mailing Address - Country:US
Mailing Address - Phone:407-215-6370
Mailing Address - Fax:407-937-2505
Practice Address - Street 1:7252 NARCOOSSEE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-5550
Practice Address - Country:US
Practice Address - Phone:407-215-6370
Practice Address - Fax:407-937-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB907UOtherBC/BS OF FLORIDA
FLB907UOtherBC/BS OF FLORIDA