Provider Demographics
NPI:1700181179
Name:MK URGENT MEDICAL CENTER INC
Entity type:Organization
Organization Name:MK URGENT MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAGY
Authorized Official - Middle Name:S
Authorized Official - Last Name:FARAG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-422-4545
Mailing Address - Street 1:2827 PALM HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1926
Mailing Address - Country:US
Mailing Address - Phone:727-422-4545
Mailing Address - Fax:727-216-6678
Practice Address - Street 1:2827 PALM HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-1926
Practice Address - Country:US
Practice Address - Phone:727-422-4545
Practice Address - Fax:727-216-6678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81763261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
H38712Medicare PIN