411 Urgent Care LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

411 URGENT CARE LLC

Practice address

17820 SE 109TH Ave Ste 108
Summerfield, FL 34491-8968

Phone

(352) 547-9378

Fax

(352) 559-3939

NPI assigned

Aug 5, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adamastor Santos, PANPI 1972577377

Title

Medical / Officer

Phone

(352) 274-4307

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adamastor A Santos, P.A.-C

  • Emergency Medicine Physician
  • Belleview, FL
  • NPI 1972577377
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1699449462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17820 SE 109TH AVE STE 108",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918968",
            "telephone_number": "352-547-9378",
            "fax_number": "352-559-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17820 SE 109TH AVE STE 108",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918968",
            "telephone_number": "352-547-9378",
            "fax_number": "352-559-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "411 URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "ADAMASTOR",
        "authorized_official_title_or_position": "MEDICAL / OFFICER",
        "authorized_official_telephone_number": "352-274-4307",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Summerfield, FL
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.