Healthcare Provider Details

I. General information

NPI: 1093661381
Provider Name (Legal Business Name): ALLIANCE MEDICAL CARE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 E 12300 S STE 2
DRAPER UT
84020-8276
US

IV. Provider business mailing address

2649 FLAMINGO LN
FORT LAUDERDALE FL
33312-4759
US

V. Phone/Fax

Practice location:
  • Phone: 210-464-3611
  • Fax: 888-329-2091
Mailing address:
  • Phone: 210-464-3611
  • Fax: 888-329-2091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FAITH BLEVINS
Title or Position: ADMIN
Credential:
Phone: 210-464-3611