Provider Demographics
NPI:1568867273
Name:911 URGENT CONVENIENT CARE CLINICS LLC
Entity Type:Organization
Organization Name:911 URGENT CONVENIENT CARE CLINICS LLC
Other - Org Name:911 URGENT CARE ON PARK BLVD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:G
Authorized Official - Last Name:BRAMLET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-209-6572
Mailing Address - Street 1:4820 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3534
Mailing Address - Country:US
Mailing Address - Phone:727-209-6572
Mailing Address - Fax:727-209-6685
Practice Address - Street 1:4820 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3534
Practice Address - Country:US
Practice Address - Phone:727-209-6572
Practice Address - Fax:727-209-6685
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DALE G BRAMLET MD PL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care