MEDICARE: UNITED RESEARCH CLINIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1100X	Research Clinic/Center

General Provider Information

NPI Number	:	1043555469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED RESEARCH CLINIC INC

Provider Business Mailing Address
First Line	:	2311 10TH AVE N
Second Line	:	STE 4
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6605
Country	:	US
Telephone Number	:	561-232-8855
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 10TH AVE N
Second Line	:	STE 4
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6605
Country	:	US
Telephone Number	:	561-232-8855
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARMANDO TOMAS
Credential	:
Telephone Number	:	561-232-8855

Provider Enumeration Date	:	12/11/2012
Last Update Date	:	12/11/2012

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