Healthcare Provider Details

I. General information

NPI: 1487264826
Provider Name (Legal Business Name): UPPERLINE HEALTHCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 09/24/2021
Certification Date: 09/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 E OAK ST STE B
KISSIMMEE FL
34744-5842
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 450
NASHVILLE TN
37205-5202
US

V. Phone/Fax

Practice location:
  • Phone: 407-846-1234
  • Fax: 407-846-9253
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL KING
Title or Position: PRESIDENT
Credential: DPM
Phone: 615-627-2204