Healthcare Provider Details

I. General information

NPI: 1417513755
Provider Name (Legal Business Name): UNLIMITED MEDICAL RESEARCH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11093 NW 138TH ST UNIT 121
HIALEAH GARDENS FL
33018-1191
US

IV. Provider business mailing address

11093 NW 138TH ST UNIT 121
HIALEAH GARDENS FL
33018-1191
US

V. Phone/Fax

Practice location:
  • Phone: 786-646-0078
  • Fax:
Mailing address:
  • Phone: 786-646-0078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSE PEREZ
Title or Position: MANAGER
Credential:
Phone: 786-423-6758