Provider Demographics
NPI:1013954700
Name:URGENT CARE CENTER OF SOUTHWEST FLORIDA LLC
Entity Type:Organization
Organization Name:URGENT CARE CENTER OF SOUTHWEST FLORIDA LLC
Other - Org Name:URGENT CARE CENTER OF SOUTHWEST
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-333-3333
Mailing Address - Street 1:12717 BREWSTER DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-1809
Mailing Address - Country:US
Mailing Address - Phone:239-333-2273
Mailing Address - Fax:239-333-2272
Practice Address - Street 1:12717 BREWSTER DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-1809
Practice Address - Country:US
Practice Address - Phone:239-333-2273
Practice Address - Fax:239-333-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042732261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care