Provider Demographics
NPI:1780930461
Name:A PLUS URGENT CARE OF HOLLYWOOD
Entity type:Organization
Organization Name:A PLUS URGENT CARE OF HOLLYWOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGMR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUCHAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:954-922-1270
Mailing Address - Street 1:1531 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-2849
Mailing Address - Country:US
Mailing Address - Phone:954-922-1270
Mailing Address - Fax:954-922-1273
Practice Address - Street 1:1531 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-2849
Practice Address - Country:US
Practice Address - Phone:954-922-1270
Practice Address - Fax:954-922-1273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6252111N00000X
FLAP1714171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty