Healthcare Provider Details

I. General information

NPI: 1124581632
Provider Name (Legal Business Name): DOCTOR UNITED GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6209 NW 18TH AVE
MIAMI FL
33147-7801
US

IV. Provider business mailing address

6209 NW 18TH AVE
MIAMI FL
33147-7801
US

V. Phone/Fax

Practice location:
  • Phone: 786-655-0529
  • Fax: 786-558-7308
Mailing address:
  • Phone: 786-655-0529
  • Fax: 786-558-7308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM MAYHOOD
Title or Position: LEGAL & REGULATORY
Credential: JD
Phone: 877-384-6337