Provider Demographics
NPI:1497135958
Name:ALOMA URGENT CARE INC
Entity Type:Organization
Organization Name:ALOMA URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHUSUDHAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOMMETI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-215-6370
Mailing Address - Street 1:7252 NARCOOSSEE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-5550
Mailing Address - Country:US
Mailing Address - Phone:407-215-6370
Mailing Address - Fax:407-978-6507
Practice Address - Street 1:7252 NARCOOSSEE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-5550
Practice Address - Country:US
Practice Address - Phone:407-215-6370
Practice Address - Fax:407-978-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-31
Last Update Date:2015-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79298261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACO82YMedicare PIN