Healthcare Provider Details

I. General information

NPI: 1528819455
Provider Name (Legal Business Name): ERICK UNLIMITED II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4526 PALM AVE
HIALEAH FL
33012-4034
US

IV. Provider business mailing address

4526 PALM AVE
HIALEAH FL
33012-4034
US

V. Phone/Fax

Practice location:
  • Phone: 786-600-7560
  • Fax: 786-643-5503
Mailing address:
  • Phone: 786-600-7560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ERICK CASTRO
Title or Position: OWNER
Credential:
Phone: 786-447-2391