Provider Demographics
NPI:1699190702
Name:SAWGRASS URGENT CARE & OCCUPATIONAL MEDICINE LLC
Entity Type:Organization
Organization Name:SAWGRASS URGENT CARE & OCCUPATIONAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUNIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAIRYS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:954-845-0188
Mailing Address - Street 1:12651 W SUNRISE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-0906
Mailing Address - Country:US
Mailing Address - Phone:954-845-0188
Mailing Address - Fax:954-845-0186
Practice Address - Street 1:12651 W SUNRISE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-0906
Practice Address - Country:US
Practice Address - Phone:954-845-0188
Practice Address - Fax:954-845-0186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103602261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care