Provider Demographics
NPI:1467814095
Name:FMD URGENT CARE LLC
Entity Type:Organization
Organization Name:FMD URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-807-6900
Mailing Address - Street 1:8140 PICTON WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1782
Mailing Address - Country:US
Mailing Address - Phone:727-807-6900
Mailing Address - Fax:727-807-6901
Practice Address - Street 1:8140 PICTON WAY STE 102
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1782
Practice Address - Country:US
Practice Address - Phone:727-807-6900
Practice Address - Fax:727-807-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care