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General NPI Number Information
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NPI Number | 1295065795
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Entity Type | Organization
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Legal Business Name | UNIVERSAL INJURED CENTER LLC
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Dates
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Enumeration Date | 01/05/2010
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 2901 W BUSCH BLVD SUITE 201
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City | TAMPA
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State | FL
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Zip | 33618-4523
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Country | US
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Telephone | 813-443-4824
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Fax | 813-443-4825
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Provider Business Mailing Address
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Address Line | 2901 W BUSCH BLVD SUITE 201
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City | TAMPA
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State | FL
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Zip | 33618-4523
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Country | US
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Telephone | 813-443-4824
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Fax | 813-443-4825
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Authorized Official
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Title or Position | OWNER
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Name | MR. NAPTHALIE NARCISSE
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Credential | LMT
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Telephone | 813-443-4824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | HCC7891
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License Number State | FL
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