1346546405 NPI number — UNITED HEALTH CARE OF FLORIDA INC

Table of content: (NPI 1346546405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346546405 NPI number — UNITED HEALTH CARE OF FLORIDA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED HEALTH CARE OF FLORIDA 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:
1346546405
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3100 SW 145TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIRAMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33027-6610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-364-0785
Provider Business Mailing Address Fax Number:
855-268-5187

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 SW 145TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIRAMAR
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33027-6610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-364-0785
Provider Business Practice Location Address Fax Number:
855-268-5187
Provider Enumeration Date:
02/07/2011

Additional Information

Authorized Official

Authorized Official Last Name:
GARLAND
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
TRAVIS
Authorized Official Title or Position:
CHIEF OPERATION OFFICER
Authorized Official Telephone Number:
954-364-0785

Provider Taxonomy Codes

  • Taxonomy code: 302R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 008462204 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015068103 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 008462203 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015068101 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015068102 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010558704 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010558711 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 008462207 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 008462211 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010558707 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015068104 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010558703 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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