Healthcare Provider Details
I. General information
NPI: 1801406244
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: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10415 MOSS PARK RD
ORLANDO FL
32832-5812
US
IV. Provider business mailing address
4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US
V. Phone/Fax
- Phone: 407-737-2751
- Fax: 407-781-5649
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
KING
Title or Position: PRESIDENT
Credential: DPM
Phone: 615-627-2204