Provider Demographics
NPI:1750433678
Name:SUNRISE URGENT CARE ASSOCIATES LLC
Entity type:Organization
Organization Name:SUNRISE URGENT CARE ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGUILA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-677-8788
Mailing Address - Street 1:13162 US HIGHWAY 301 S
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-7410
Mailing Address - Country:US
Mailing Address - Phone:813-677-8788
Mailing Address - Fax:136-778-8068
Practice Address - Street 1:13162 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7410
Practice Address - Country:US
Practice Address - Phone:813-677-8788
Practice Address - Fax:813-677-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34819Medicare PIN