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General NPI Number Information
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NPI Number | 1154428597
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Entity Type | Organization
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Legal Business Name | ULTRA HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 21913 US HWY 19 N
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City | CLEARWATER
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State | FL
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Zip | 33765
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Country | US
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Telephone | 727-669-5525
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Fax | 727-669-8589
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Provider Business Mailing Address
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Address Line | 21913 US HWY 19 N
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City | CLEARWATER
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State | FL
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Zip | 33765
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Country | US
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Telephone | 727-669-5525
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Fax | 727-669-8589
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DONNA JEAN DAMIANI
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Credential |
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Telephone | 727-669-5525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number | HCC5325
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC5325
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License Number State | FL
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