Provider Demographics
NPI:1265672703
Name:UK SERVICE GROUP INC
Entity Type:Organization
Organization Name:UK SERVICE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-336-7990
Mailing Address - Street 1:16235 SW 117TH AVE
Mailing Address - Street 2:13
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16235 SW 117TH AVE
Practice Address - Street 2:13
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1644
Practice Address - Country:US
Practice Address - Phone:786-336-7990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty