| Ultra Medical Center, Corp | |
|
711 Nw 23rd Ave Suite 304 Miami FL 33125-3298 | |
| (305) 644-7407 | |
| (305) 644-7408 |
| Full Name | Ultra Medical Center, Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 711 Nw 23rd Ave, Miami, Florida |
| Authorized Official Name and Position | Jose N Gonzalez (OWNER) |
| Authorized Official Contact | 3056447407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ultra Medical Center, Corp 711 Nw 23rd Ave Suite 304 Miami FL 33125-3298 Ph: (305) 644-7407 | Ultra Medical Center, Corp 711 Nw 23rd Ave Suite 304 Miami FL 33125-3298 Ph: (305) 644-7407 |
| NPI Number | 1629028865 |
|---|---|
| Provider Enumeration Date | 05/10/2006 |
| Last Update Date | 10/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629028865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 136410067 (Florida) | Primary |
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