Provider Demographics
NPI:1376853663
Name:INTERCOASTAL URGENT CARE ASSOCIATES PL
Entity Type:Organization
Organization Name:INTERCOASTAL URGENT CARE ASSOCIATES PL
Other - Org Name:AFC URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEADMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-504-2025
Mailing Address - Street 1:1530 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-4412
Mailing Address - Country:US
Mailing Address - Phone:727-821-8700
Mailing Address - Fax:727-821-8770
Practice Address - Street 1:1530 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-4412
Practice Address - Country:US
Practice Address - Phone:727-821-8700
Practice Address - Fax:727-821-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care