Provider Demographics
NPI:1306182712
Name:UNIVERSAL MEDICAL CARE CENTER, L.L.C.
Entity Type:Organization
Organization Name:UNIVERSAL MEDICAL CARE CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP REGIONAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-509-3705
Mailing Address - Street 1:928 SW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4240
Mailing Address - Country:US
Mailing Address - Phone:305-265-5744
Mailing Address - Fax:305-265-5745
Practice Address - Street 1:928 SW 82ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4240
Practice Address - Country:US
Practice Address - Phone:305-265-5744
Practice Address - Fax:305-265-5745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty