MEDICARE: UPPERLINE HEALTHCARE, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist

General Provider Information

NPI Number	:	1043885056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPPERLINE HEALTHCARE, PC

Provider Business Mailing Address
First Line	:	4101 CHARLOTTE AVE STE F185
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-4066
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1140 SW BASCOM NORRIS DR STE 102
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32025-1329
Country	:	US
Telephone Number	:	386-755-7776
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL KING
Credential	:
Telephone Number	:	407-219-5402

Provider Enumeration Date	:	05/21/2021
Last Update Date	:	06/02/2026

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