Organization
PALM HARBOR PEDIATRIC URGENT CARE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS MARAMARA MD (PROVIDER/OWNER)
(727) 787-5439
Entity
Organization
Contact information
Practice address
36458 US HIGHWAY 19 N, PALM HARBOR, FL 34684-1330
(727) 787-5439
(727) 787-6221
Mailing address
PO BOX 23863, TAMPA, FL 33623-3863
(727) 823-2188
(727) 823-9502
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196501
WELLCARE
FL
01
—
220597
AMERIGROUP
—
05
—
271730100
—
FL
01
—
282538
AVMED
—
01
—
B903Q
BCBS
FL
Enumeration date
09/28/2006
Last updated
12/03/2008
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