MEDICARE: UNIVERSITY HEALTH CARE FLAGLER 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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1457654303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY HEALTH CARE FLAGLER INC.

Provider Business Mailing Address
First Line	:	8420 W FLAGLER ST
Second Line	:	SUITE 120
City	:	MIAMI
State	:	FL
Zip	:	33144-2045
Country	:	US
Telephone Number	:	305-207-4443
Fax Number	:	305-207-4442

Provider Business Practice Location Address
First Line	:	8420 W FLAGLER ST
Second Line	:	SUITE 120
City	:	MIAMI
State	:	FL
Zip	:	33144-2045
Country	:	US
Telephone Number	:	305-207-4443
Fax Number	:	305-207-4442

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MICHAL QUEVEDO
Credential	:
Telephone Number	:	305-207-4443

Provider Enumeration Date	:	12/15/2010
Last Update Date	:	12/15/2010

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