Provider Demographics
NPI:1851687321
Name:COMPLETE URGENT HEALTHCARE LLC
Entity Type:Organization
Organization Name:COMPLETE URGENT HEALTHCARE LLC
Other - Org Name:BOCA REGIONAL URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-309-7815
Mailing Address - Street 1:20665 LYONS RD
Mailing Address - Street 2:#A3
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3947
Mailing Address - Country:US
Mailing Address - Phone:561-309-7815
Mailing Address - Fax:
Practice Address - Street 1:20665 LYONS RD
Practice Address - Street 2:#A3
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3947
Practice Address - Country:US
Practice Address - Phone:561-309-7815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207P00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty