Healthcare Provider Details

I. General information

NPI: 1629071774
Provider Name (Legal Business Name): UNIVERSITY IMAGED GUIDED THERAPHY CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 NW 8TH AVE STE 200
BOCA RATON FL
33431-6437
US

IV. Provider business mailing address

3848 NW 8TH AVE STE 200
BOCA RATON FL
33431-6437
US

V. Phone/Fax

Practice location:
  • Phone: 561-362-9191
  • Fax: 561-394-5674
Mailing address:
  • Phone: 561-362-9191
  • Fax: 561-394-5674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateFL

VIII. Authorized Official

Name: FRED STEINBERG
Title or Position: PRESIDENT
Credential:
Phone: 561-362-9191