Provider Demographics
NPI:1770909152
Name:WINTER GARDEN URGENT CARE, LLC
Entity type:Organization
Organization Name:WINTER GARDEN URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:HARBINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GHULLDU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-370-9783
Mailing Address - Street 1:736 S DILLARD ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3908
Mailing Address - Country:US
Mailing Address - Phone:407-656-7000
Mailing Address - Fax:407-656-7005
Practice Address - Street 1:736 S DILLARD ST UNIT A
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3908
Practice Address - Country:US
Practice Address - Phone:407-656-0505
Practice Address - Fax:407-656-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care