Provider Demographics
NPI:1710964978
Name:UNITED HEALTH CARE GROUP, INC.
Entity Type:Organization
Organization Name:UNITED HEALTH CARE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEONARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-364-2393
Mailing Address - Street 1:1840 W 49TH ST
Mailing Address - Street 2:SUITE 605
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2962
Mailing Address - Country:US
Mailing Address - Phone:305-364-2393
Mailing Address - Fax:305-364-9614
Practice Address - Street 1:1840 W 49TH ST
Practice Address - Street 2:SUITE 605
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2962
Practice Address - Country:US
Practice Address - Phone:305-364-2393
Practice Address - Fax:305-364-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4767261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3944Medicare ID - Type UnspecifiedCLINIC