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General NPI Number Information
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NPI Number | 1144775404
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Entity Type | Organization
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Legal Business Name | UNITED HEALTH GROUP
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 19811 GULF BLVD 401
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City | INDIAN SHORES
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State | FL
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Zip | 33785-2387
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Country | US
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Telephone | 303-889-9604
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 994
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City | INDIAN ROCKS BEACH
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State | FL
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Zip | 33785-0994
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Country | US
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Telephone | 303-889-9604
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Fax |
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Authorized Official
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Title or Position | DMD, R.PH.
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Name | DR. JOHN MAJOR
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Credential |
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Telephone | 303-889-9604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 53616
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License Number State | FL
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