Provider Demographics
NPI:1912306689
Name:ULTRA CARE MEDICAL CENTERS LLC
Entity Type:Organization
Organization Name:ULTRA CARE MEDICAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSVALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SARDUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-835-0413
Mailing Address - Street 1:6801 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4742
Mailing Address - Country:US
Mailing Address - Phone:305-835-0413
Mailing Address - Fax:
Practice Address - Street 1:6801 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4742
Practice Address - Country:US
Practice Address - Phone:305-835-0413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10127261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIG992AMedicare PIN