Healthcare Provider Details

I. General information

NPI: 1265672703
Provider Name (Legal Business Name): UK SERVICE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16235 SW 117TH AVE 13
MIAMI FL
33177-1644
US

IV. Provider business mailing address

16235 SW 117TH AVE 13
MIAMI FL
33177-1644
US

V. Phone/Fax

Practice location:
  • Phone: 786-336-7990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MANUEL GONZALEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-336-7990