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General NPI Number Information
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NPI Number | 1912615667
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Entity Type | Organization
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Legal Business Name | ULTRAMAR SERVICES LLC
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 11401 SW 40TH ST STE 360
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City | MIAMI
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State | FL
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Zip | 33165-3340
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Country | US
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Telephone | 786-424-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 11401 SW 40TH ST STE 360 1062 NW 123 CT
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City | MIAMI
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State | FL
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Zip | 33165-3340
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Country | US
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Telephone | 786-362-5816
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Fax | 786-963-1007
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARYS L GARGALLO DOMINGUEZ
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Credential |
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Telephone | 786-351-9318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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