Provider Demographics
NPI:1407616998
Name:UNIQSTIC LLC
Entity Type:Organization
Organization Name:UNIQSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AYOKUNLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:OJUTALAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-344-7357
Mailing Address - Street 1:501 N ORLANDO AVE STE 313-442
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-7313
Mailing Address - Country:US
Mailing Address - Phone:770-344-7357
Mailing Address - Fax:
Practice Address - Street 1:1052 W MORSE BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3760
Practice Address - Country:US
Practice Address - Phone:689-319-3904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332100000XSuppliersDepartment of Veterans Affairs (VA) Pharmacy
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
No261QA0900XAmbulatory Health Care FacilitiesClinic/CenterAmputee
No261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No347E00000XTransportation ServicesTransportation Broker