Provider Demographics
NPI:1578926739
Name:CITRUS PARK FAMILY CARE LLC
Entity Type:Organization
Organization Name:CITRUS PARK FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-960-1100
Mailing Address - Street 1:6182 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4014
Mailing Address - Country:US
Mailing Address - Phone:813-960-1100
Mailing Address - Fax:813-960-1101
Practice Address - Street 1:6182 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4014
Practice Address - Country:US
Practice Address - Phone:813-960-1100
Practice Address - Fax:813-960-1101
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URGENT CARE EXPRESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty