Provider Demographics
NPI:1578664512
Name:UNIVERSAL MEDICAL OFFICE CORP
Entity Type:Organization
Organization Name:UNIVERSAL MEDICAL OFFICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-644-9459
Mailing Address - Street 1:8150 SW 8TH ST
Mailing Address - Street 2:STE 113
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4263
Mailing Address - Country:US
Mailing Address - Phone:305-262-5004
Mailing Address - Fax:305-263-8050
Practice Address - Street 1:8150 SW 8TH ST
Practice Address - Street 2:STE 113
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4263
Practice Address - Country:US
Practice Address - Phone:305-262-5004
Practice Address - Fax:305-263-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty