Provider Demographics
NPI:1740045236
Name:UNIVERSAL HEALTH COMMUNITY SERVICE
Entity type:Organization
Organization Name:UNIVERSAL HEALTH COMMUNITY SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-648-4931
Mailing Address - Street 1:8551 NW SOUTH RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7426
Mailing Address - Country:US
Mailing Address - Phone:305-603-9344
Mailing Address - Fax:305-631-2180
Practice Address - Street 1:8551 NW SOUTH RIVER DR
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-7426
Practice Address - Country:US
Practice Address - Phone:305-603-9344
Practice Address - Fax:305-631-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty