| Ultamed Corporation | |
|
2307 Sea Island Dr Fort Lauderdale FL 33301-1574 | |
| (949) 468-9301 | |
| Not Available |
| Full Name | Ultamed Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 2307 Sea Island Dr, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Laura Eaton-jankov (CEO/ PRESIDENT) |
| Authorized Official Contact | 9494689301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ultamed Corporation 2307 Sea Island Dr Fort Lauderdale FL 33301-1574 Ph: () - | Ultamed Corporation 2307 Sea Island Dr Fort Lauderdale FL 33301-1574 Ph: (949) 468-9301 |
| NPI Number | 1518683531 |
|---|---|
| Provider Enumeration Date | 10/12/2022 |
| Last Update Date | 10/12/2022 |
| Medicare PECOS PAC ID | 3577935808 |
|---|---|
| Medicare Enrollment ID | O20230214001101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518683531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Laura Np Eaton-jankov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356064661 PECOS PAC ID: 6204208531 Enrollment ID: I20230214001149 |
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