Provider Demographics
NPI:1558690768
Name:UNIVERSAL MEDICAL CENTER PLLC
Entity Type:Organization
Organization Name:UNIVERSAL MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-651-1300
Mailing Address - Street 1:3800 S OCEAN DR
Mailing Address - Street 2:SUITE G3
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2927
Mailing Address - Country:US
Mailing Address - Phone:732-735-8312
Mailing Address - Fax:
Practice Address - Street 1:3800 S OCEAN DR
Practice Address - Street 2:G3
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-2927
Practice Address - Country:US
Practice Address - Phone:732-735-8312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88879208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty