# 411 URGENT CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699449462
- **Authorized official:** ADAMASTOR SANTOS PA (MEDICAL / OFFICER)
- **Authorized official phone:** (352) 274-4307

## Contact information

- **Practice address:** 17820 SE 109TH AVE STE 108, SUMMERFIELD, FL 34491-8968
- **Practice address phone:** (352) 547-9378
- **Practice address fax:** (352) 559-3939
- **Mailing address:** 17820 SE 109TH AVE STE 108, SUMMERFIELD, FL 34491-8968
- **Mailing address phone:** (352) 547-9378
- **Mailing address fax:** (352) 559-3939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/05/2021
- **Last updated:** 08/26/2021