Provider Demographics
NPI:1891034005
Name:U.S. MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:U.S. MEDICAL GROUP, INC.
Other - Org Name:FREESTANDING MODULAR SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:407-849-2288
Mailing Address - Street 1:1405 S ORANGE AVE
Mailing Address - Street 2:SUITE 603
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2154
Mailing Address - Country:US
Mailing Address - Phone:407-849-2288
Mailing Address - Fax:407-849-6412
Practice Address - Street 1:7765 S COUNTY ROAD 231
Practice Address - Street 2:
Practice Address - City:LAKE BUTLER
Practice Address - State:FL
Practice Address - Zip Code:32054-5721
Practice Address - Country:US
Practice Address - Phone:386-496-2833
Practice Address - Fax:386-496-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL149604181261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1073629234OtherNPI