Provider Demographics
NPI:1588036065
Name:PARAMOUNT URGENT CARE INC
Entity Type:Organization
Organization Name:PARAMOUNT URGENT CARE INC
Other - Org Name:PARAMOUNT URGENT CARE ORLANDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTERLING
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:407-226-1906
Mailing Address - Street 1:805 E COUNTY ROAD 466
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-4205
Mailing Address - Country:US
Mailing Address - Phone:352-674-9218
Mailing Address - Fax:352-259-6069
Practice Address - Street 1:8972 TURKEY LAKE RD STE A300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7377
Practice Address - Country:US
Practice Address - Phone:407-226-1906
Practice Address - Fax:407-226-1910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARAMOUNT URGENT CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104065261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center