Provider Demographics
NPI:1326541897
Name:URGENT FAMILY CLINIC, LLC
Entity Type:Organization
Organization Name:URGENT FAMILY CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-915-2718
Mailing Address - Street 1:11601 S ORANGE BLOSSOM TRL STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-9437
Mailing Address - Country:US
Mailing Address - Phone:407-271-4605
Mailing Address - Fax:407-271-4740
Practice Address - Street 1:11601 S ORANGE BLOSSOM TRL STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-9437
Practice Address - Country:US
Practice Address - Phone:407-271-4605
Practice Address - Fax:407-271-4740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care