Provider Demographics
NPI:1356490411
Name:ULTRASOUND UNLIMITED INC
Entity Type:Organization
Organization Name:ULTRASOUND UNLIMITED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:386-446-4195
Mailing Address - Street 1:PO BOX 351639
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32135-1639
Mailing Address - Country:US
Mailing Address - Phone:386-446-4195
Mailing Address - Fax:386-446-4197
Practice Address - Street 1:14 OFFICE PARK DR
Practice Address - Street 2:STE7
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3864
Practice Address - Country:US
Practice Address - Phone:386-446-4195
Practice Address - Fax:386-446-4197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1599Medicare ID - Type UnspecifiedIDTF ULTRASOUND