Healthcare Provider Details

I. General information

NPI: 1275257222
Provider Name (Legal Business Name): UNITED DOCTORS UNIDOCTORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA PASEO DE LA COSTANERA
LAS TERRENAS SAMANA
99999
DO

IV. Provider business mailing address

PO BOX 11597
FORT LAUDERDALE FL
33339-1597
US

V. Phone/Fax

Practice location:
  • Phone: 829-534-1980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EVANDER CABRERA
Title or Position: MANAGER
Credential: MD
Phone: 954-526-9751