Provider Demographics
NPI:1669921094
Name:US NATIONAL HEALTHCARE CLINICS, INC
Entity type:Organization
Organization Name:US NATIONAL HEALTHCARE CLINICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RONETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-878-3090
Mailing Address - Street 1:485 N US HIGHWAY 17 92
Mailing Address - Street 2:SUITE 415
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4488
Mailing Address - Country:US
Mailing Address - Phone:386-878-3090
Mailing Address - Fax:407-289-4056
Practice Address - Street 1:8043 SPYGLASS HILL RD
Practice Address - Street 2:B
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8563
Practice Address - Country:US
Practice Address - Phone:386-878-3090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty