Healthcare Provider Details

I. General information

NPI: 1942319884
Provider Name (Legal Business Name): UNITED OUTREACH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5521 N UNIVERSITY DR SUITE104
CORAL SPRINGS FL
33067-4648
US

IV. Provider business mailing address

5521 N UNIVERSITY DR SUITE104
CORAL SPRINGS FL
33067-4648
US

V. Phone/Fax

Practice location:
  • Phone: 888-803-6471
  • Fax: 888-832-0632
Mailing address:
  • Phone: 888-803-6471
  • Fax: 888-832-0632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberK3040
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberK3040
License Number StateFL

VIII. Authorized Official

Name: MR. PETER TALATI
Title or Position: PRESIDENT
Credential: RPT
Phone: 888-803-6471