Provider Demographics
NPI:1326681016
Name:ULTRA FAST URGENT CARE
Entity Type:Organization
Organization Name:ULTRA FAST URGENT CARE
Other - Org Name:ULTRA FAST URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VENKATA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BIREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-465-9999
Mailing Address - Street 1:502 S MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3039
Mailing Address - Country:US
Mailing Address - Phone:813-877-5111
Mailing Address - Fax:813-877-1222
Practice Address - Street 1:502 S MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3039
Practice Address - Country:US
Practice Address - Phone:813-877-5111
Practice Address - Fax:813-877-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care