Provider Demographics
NPI:1821487943
Name:THE MEDICAL CITY URGENT CARE
Entity Type:Organization
Organization Name:THE MEDICAL CITY URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NECUZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-422-6821
Mailing Address - Street 1:3595 W 20TH AVE
Mailing Address - Street 2:STE 125-130
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3595 W 20TH AVE
Practice Address - Street 2:STE 125-130
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4533
Practice Address - Country:US
Practice Address - Phone:786-422-6821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MEDICAL CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care