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NPI Code Detail

MEDICARE: UNIVERSITY MEDICAL SERVICE ASSOCIATION INC

MEDICARE: UNIVERSITY MEDICAL SERVICE ASSOCIATION INC
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
1103TC0700XClinical Psychologist
21041C0700XClinical Social Worker
3133V00000XRegistered Dietitian
4363L00000XNurse Practitioner
52084P0800XPsychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100537OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1205876125
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY MEDICAL SERVICE ASSOCIATION INC
Provider Business Mailing Address
First Line : PO BOX 917770
Second Line :
City : ORLANDO
State : FL
Zip : 32891-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3515 E FLETCHER AVE
Second Line : MDC 14
City : TAMPA
State : FL
Zip : 33613-4706
Country : US
Telephone Number : 813-974-8900
Fax Number : 813-974-3223
Authorized Official
Title or Position : CFO USF HEALTH
Name : RICHARD J SOBIERAY
Credential :
Telephone Number : 813-821-8038
Provider Enumeration Date : 06/08/2006
Last Update Date : 02/17/2022

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Directions to “UNIVERSITY MEDICAL SERVICE ASSOCIATION INC ” Practice Location

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