Provider Demographics
NPI:1255403465
Name:UNIVERSAL HEALTH CARE, INC
Entity type:Organization
Organization Name:UNIVERSAL HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:SHEESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-456-6506
Mailing Address - Street 1:150 2ND AVE N
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3327
Mailing Address - Country:US
Mailing Address - Phone:727-822-8477
Mailing Address - Fax:727-823-3840
Practice Address - Street 1:150 2ND AVE N
Practice Address - Street 2:SUITE 400
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3327
Practice Address - Country:US
Practice Address - Phone:727-822-8477
Practice Address - Fax:727-823-3840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL184302R00000X, 305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered302R00000XManaged Care OrganizationsHealth Maintenance Organization
Not Answered305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15041006Medicaid
FL15041006Medicaid
FLH5820Medicare ID - Type Unspecified
FLH5404Medicare ID - Type Unspecified