Provider Demographics
NPI:1811210735
Name:LAVENDER HEALTH CARE OF FLORIDA, LLLP
Entity Type:Organization
Organization Name:LAVENDER HEALTH CARE OF FLORIDA, LLLP
Other - Org Name:AFC URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BUETE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-688-6951
Mailing Address - Street 1:2901 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5106
Mailing Address - Country:US
Mailing Address - Phone:727-688-6951
Mailing Address - Fax:941-364-4371
Practice Address - Street 1:2901 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5106
Practice Address - Country:US
Practice Address - Phone:727-688-6951
Practice Address - Fax:941-364-4371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC8996OtherHEALTH CARE CLINIC LICENSE
FL10D2012734OtherCLIA NUMBER