Provider Demographics
NPI:1235240276
Name:UNIVERSAL MEDICAL CENTRE
Entity Type:Organization
Organization Name:UNIVERSAL MEDICAL CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SMITH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-893-8606
Mailing Address - Street 1:13377 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4134
Mailing Address - Country:US
Mailing Address - Phone:305-893-8306
Mailing Address - Fax:305-893-8354
Practice Address - Street 1:13377 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4134
Practice Address - Country:US
Practice Address - Phone:305-893-8306
Practice Address - Fax:305-893-8354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL058309261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58051Medicaid
H64819Medicare ID - Type Unspecified
FL58051Medicaid