Provider Demographics
NPI:1114583309
Name:DOCTORS UNITED GROUP INC
Entity Type:Organization
Organization Name:DOCTORS UNITED GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-206-6196
Mailing Address - Street 1:714 NW 62ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-4332
Mailing Address - Country:US
Mailing Address - Phone:305-603-8200
Mailing Address - Fax:305-603-8461
Practice Address - Street 1:714 NW 62ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-4332
Practice Address - Country:US
Practice Address - Phone:305-603-8200
Practice Address - Fax:305-603-8461
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTORS UNITED GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center