Provider Demographics
NPI:1891258307
Name:DOCTORS UNITED GROUP, INC
Entity Type:Organization
Organization Name:DOCTORS UNITED GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-206-6196
Mailing Address - Street 1:1498 NW 54TH ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-3911
Mailing Address - Country:US
Mailing Address - Phone:305-603-8200
Mailing Address - Fax:305-603-8461
Practice Address - Street 1:4212 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7629
Practice Address - Country:US
Practice Address - Phone:305-821-5525
Practice Address - Fax:786-342-6017
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTORS UNITED GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center