Provider Demographics
NPI:1447753751
Name:ULTRA ROYAL COMFORT CARE NURSING REGISTRY
Entity Type:Organization
Organization Name:ULTRA ROYAL COMFORT CARE NURSING REGISTRY
Other - Org Name:ULTRA ROYAL COMFORT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-541-3216
Mailing Address - Street 1:6953 SW 36TH DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6666
Mailing Address - Country:US
Mailing Address - Phone:786-541-3216
Mailing Address - Fax:954-272-7668
Practice Address - Street 1:6953 SW 36TH DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6666
Practice Address - Country:US
Practice Address - Phone:786-541-3216
Practice Address - Fax:954-272-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235179376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty