Provider Demographics
NPI:1811335144
Name:URGENT CARE OF FORT LAUDERDALE INC
Entity type:Organization
Organization Name:URGENT CARE OF FORT LAUDERDALE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-368-3430
Mailing Address - Street 1:1820 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3725
Mailing Address - Country:US
Mailing Address - Phone:954-368-3430
Mailing Address - Fax:
Practice Address - Street 1:1820 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3725
Practice Address - Country:US
Practice Address - Phone:954-771-7900
Practice Address - Fax:954-771-6863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-09
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009252400Medicaid