Provider Demographics
NPI:1700658697
Name:UNIVERSAL FAMILY CARE, LLC.
Entity Type:Organization
Organization Name:UNIVERSAL FAMILY CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCELIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:904-337-1268
Mailing Address - Street 1:101 LOCHNAGAR MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-6674
Mailing Address - Country:US
Mailing Address - Phone:484-844-5959
Mailing Address - Fax:720-600-0873
Practice Address - Street 1:4319 SALISBURY RD STE 102
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-0941
Practice Address - Country:US
Practice Address - Phone:904-723-8034
Practice Address - Fax:720-600-0873
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSAL FAMILY HEALTH SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty
No173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical ExaminerGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty
No342000000XTransportation ServicesTransportation Network Company
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty