Provider Demographics
NPI:1760848758
Name:CONCIERGE MEDHEALTH CLINIC LLC
Entity Type:Organization
Organization Name:CONCIERGE MEDHEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GALUSZKA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:941-755-5608
Mailing Address - Street 1:6060 26TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-4401
Mailing Address - Country:US
Mailing Address - Phone:941-755-5608
Mailing Address - Fax:941-755-7097
Practice Address - Street 1:6060 26TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-4401
Practice Address - Country:US
Practice Address - Phone:941-755-5608
Practice Address - Fax:941-755-7097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care