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General NPI Number Information
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NPI Number | 1154550002
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Entity Type | Organization
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Legal Business Name | UNIVERSAL CONQUEST INVESTMENT, INC.
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Dates
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Enumeration Date | 07/13/2009
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 2116 NW 76TH WAY
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City | MARGATE
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State | FL
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Zip | 33063-7927
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Country | US
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Telephone | 954-970-9490
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Fax | 954-495-8888
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Provider Business Mailing Address
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Address Line | 2116 NW 76TH WAY
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City | MARGATE
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State | FL
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Zip | 33063-7927
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Country | US
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Telephone | 954-970-9490
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Fax | 954-495-8888
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. OMAR D MAHARAJ
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Credential |
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Telephone | 954-465-6627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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