Provider Demographics
NPI:1427197250
Name:DOCTORS R US WALK-IN CLINIC, INC.
Entity Type:Organization
Organization Name:DOCTORS R US WALK-IN CLINIC, INC.
Other - Org Name:DOCTORS R US WALK-IN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADORNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-890-0705
Mailing Address - Street 1:6821 W HILLSBOROUGH AVE
Mailing Address - Street 2:#19
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-5003
Mailing Address - Country:US
Mailing Address - Phone:813-890-0705
Mailing Address - Fax:813-890-0710
Practice Address - Street 1:6821 W HILLSBOROUGH AVE
Practice Address - Street 2:#19
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5003
Practice Address - Country:US
Practice Address - Phone:813-890-0705
Practice Address - Fax:813-890-0710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259601600Medicaid
FL6600433OtherUNITED HMO PCP
FLB902POtherBC BS
FL5807OtherPPO'S AND WORK COMP
FL120805OtherHUMANA HMO PCP
FL282269OtherAVMED
FL6600432OtherUNITED UCC
FL132819OtherAETNA HMO PCP
FL9179149OtherAETNA UCC
FL6600432OtherUNITED UCC