Provider Demographics
NPI:1336515451
Name:UNIVERSAL MEDICAL GROUP OF NORTH MIAMI BEACH INC
Entity Type:Organization
Organization Name:UNIVERSAL MEDICAL GROUP OF NORTH MIAMI BEACH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESPERANZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCE-NUENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-776-7698
Mailing Address - Street 1:17064 WEST DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 17064/17068
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160
Mailing Address - Country:US
Mailing Address - Phone:305-650-1942
Mailing Address - Fax:305-952-3118
Practice Address - Street 1:17064 WEST DIXIE HIGHWAY
Practice Address - Street 2:SUITE 17064/17068
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:305-650-1942
Practice Address - Fax:305-952-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center