Provider Demographics
NPI:1609174358
Name:URGICARE TAMPA, LLC
Entity Type:Organization
Organization Name:URGICARE TAMPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZULF
Authorized Official - Middle Name:
Authorized Official - Last Name:GOKAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-397-7566
Mailing Address - Street 1:PO BOX 1666
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-1666
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3345 S DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-7817
Practice Address - Country:US
Practice Address - Phone:813-831-7722
Practice Address - Fax:813-381-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL242580207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty