Healthcare Provider Details

I. General information

NPI: 1851169429
Provider Name (Legal Business Name): MR. ULYSSES DUNCAN BISSELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 NW 7TH AVE STE 300
MIAMI FL
33136-1112
US

IV. Provider business mailing address

109 W MONUMENT ST APT 2B
BALTIMORE MD
21201-4708
US

V. Phone/Fax

Practice location:
  • Phone: 305-902-6347
  • Fax:
Mailing address:
  • Phone: 203-832-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: