Provider Demographics
NPI:1821369828
Name:MARC E. UMLAS, M.D., PA
Entity Type:Organization
Organization Name:MARC E. UMLAS, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:UMLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-532-4224
Mailing Address - Street 1:4302 ALTON ROAD
Mailing Address - Street 2:SUITE 950
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2890
Mailing Address - Country:US
Mailing Address - Phone:305-532-4224
Mailing Address - Fax:305-532-5594
Practice Address - Street 1:4302 ALTON ROAD
Practice Address - Street 2:SUITE 950
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2890
Practice Address - Country:US
Practice Address - Phone:305-532-4224
Practice Address - Fax:305-532-5594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066812207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF55433Medicare UPIN