1235155839 NPI number — UNITED MEDICAL CONSULTANTS, INC.

Table of content: (NPI 1235155839)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235155839 NPI number — UNITED MEDICAL CONSULTANTS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED MEDICAL CONSULTANTS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235155839
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 290070
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVIE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33329-0070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-252-0109
Provider Business Mailing Address Fax Number:
954-252-0690

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5400 S UNIVERSITY DR STE 416A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVIE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-252-0109
Provider Business Practice Location Address Fax Number:
954-252-0690
Provider Enumeration Date:
07/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WINTON
Authorized Official First Name:
NATHAN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
954-252-0109

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 884460700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 005708057 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 884460700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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