Provider Demographics
NPI:1649408642
Name:UTMOST HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:UTMOST HEALTHCARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYUNGBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-651-7019
Mailing Address - Street 1:111 NW 183RD STREET, SUITE 402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169
Mailing Address - Country:US
Mailing Address - Phone:305-651-7019
Mailing Address - Fax:855-621-0979
Practice Address - Street 1:111 NW 183RD STREET, SUITE 402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169
Practice Address - Country:US
Practice Address - Phone:305-651-7019
Practice Address - Fax:855-621-0979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014916500Medicaid
FL109659Medicare Oscar/Certification