Provider Demographics
NPI:1467786608
Name:PINES URGENT CARE MEDICAL CENTER
Entity Type:Organization
Organization Name:PINES URGENT CARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:VARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-438-4112
Mailing Address - Street 1:192 S FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1768
Mailing Address - Country:US
Mailing Address - Phone:954-438-4112
Mailing Address - Fax:954-438-4315
Practice Address - Street 1:192 S FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1768
Practice Address - Country:US
Practice Address - Phone:954-438-4112
Practice Address - Fax:954-438-4315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8571261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care