Provider Demographics
NPI:1144739806
Name:NIGHT OWL URGENT CARE CENTER LLC
Entity Type:Organization
Organization Name:NIGHT OWL URGENT CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORP PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEKHAR
Authorized Official - Middle Name:V
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-537-4803
Mailing Address - Street 1:3347 SO STATE RD 7
Mailing Address - Street 2:200
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8148
Mailing Address - Country:US
Mailing Address - Phone:561-537-4803
Mailing Address - Fax:561-795-4036
Practice Address - Street 1:3347 SO STATE RD 7
Practice Address - Street 2:200
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8148
Practice Address - Country:US
Practice Address - Phone:561-537-4803
Practice Address - Fax:561-795-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME47072OtherMEDICAL LICENSE