Provider Demographics
NPI:1043757438
Name:UNITED AMERICAN MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:UNITED AMERICAN MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAMPILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-418-0272
Mailing Address - Street 1:3485 W FLAGLER ST
Mailing Address - Street 2:300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1042
Mailing Address - Country:US
Mailing Address - Phone:305-418-0272
Mailing Address - Fax:786-431-5523
Practice Address - Street 1:3485 W FLAGLER ST
Practice Address - Street 2:300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1042
Practice Address - Country:US
Practice Address - Phone:305-418-0272
Practice Address - Fax:786-431-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center