Healthcare Provider Details

I. General information

NPI: 1649747924
Provider Name (Legal Business Name): UNLIMITED MEDICAL SERVICES OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4227 13TH ST
SAINT CLOUD FL
34769-6732
US

IV. Provider business mailing address

5564 E GRANT ST
ORLANDO FL
32822-1666
US

V. Phone/Fax

Practice location:
  • Phone: 321-235-6230
  • Fax:
Mailing address:
  • Phone: 321-235-6230
  • Fax: 321-235-6246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MILADY REYES
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 321-235-6230