Provider Demographics
NPI:1508014812
Name:UBSF, INC.
Entity Type:Organization
Organization Name:UBSF, INC.
Other - Org Name:ORIENTAL WELLNESS CENTER & SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHORT-MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, LE
Authorized Official - Phone:813-681-6333
Mailing Address - Street 1:749 W LUMSDEN RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6261
Mailing Address - Country:US
Mailing Address - Phone:813-681-6333
Mailing Address - Fax:813-681-6330
Practice Address - Street 1:749 W LUMSDEN RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6261
Practice Address - Country:US
Practice Address - Phone:813-681-6333
Practice Address - Fax:813-681-6330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
FLMM20757225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty