Provider Demographics
NPI:1255628475
Name:URGENTCARE USA FISHHAWK
Entity type:Organization
Organization Name:URGENTCARE USA FISHHAWK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SALVATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-681-2111
Mailing Address - Street 1:5464 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-2853
Mailing Address - Country:US
Mailing Address - Phone:813-681-2111
Mailing Address - Fax:813-681-2611
Practice Address - Street 1:5464 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-2853
Practice Address - Country:US
Practice Address - Phone:813-681-2111
Practice Address - Fax:813-681-2611
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URGENT CARE USA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7634261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care