Provider Demographics
NPI:1477201523
Name:UNITED A & E HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:UNITED A & E HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:954-687-5594
Mailing Address - Street 1:5317 TATTINGER LN
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5224
Mailing Address - Country:US
Mailing Address - Phone:954-687-5594
Mailing Address - Fax:
Practice Address - Street 1:5317 TATTINGER LN
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5224
Practice Address - Country:US
Practice Address - Phone:954-687-5594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care