Provider Demographics
NPI:1639750458
Name:UNIVERSAL MEDICAL INSTITUTE
Entity Type:Organization
Organization Name:UNIVERSAL MEDICAL INSTITUTE
Other - Org Name:UMC FREE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL OPERATIONS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-974-5995
Mailing Address - Street 1:700 NW 183RD ST STE B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4250
Mailing Address - Country:US
Mailing Address - Phone:305-974-5995
Mailing Address - Fax:305-974-5957
Practice Address - Street 1:700 NW 183RD ST STE B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4250
Practice Address - Country:US
Practice Address - Phone:305-974-5995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health