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Organization
BAYSIDE URGENT CARE CENTER INC.
Active
Organization
BAYSIDE URGENT CARE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD PETERKIN WALLACE MD (PRESIDENT/CEO)
(813) 508-2225
Entity
Organization
Contact information
Practice address
1001 S FORT HARRISON AVE, SUITE 101, CLEARWATER, FL 33756-3905
(813) 508-2225
(813) 920-4999
Mailing address
10030 NEW PARKE RD, TAMPA, FL 33626-5414
(813) 508-2225
(813) 920-4999
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
BTR-0029514
FL
Other
Enumeration date
08/21/2011
Last updated
08/21/2011
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