MEDICARE: UNIVERSAL FAMILY MEDICAL CENTER PA

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1528373065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL FAMILY MEDICAL CENTER PA

Provider Business Mailing Address
First Line	:	601 N CONGRESS AVE STE 408
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-4640
Country	:	US
Telephone Number	:	561-276-1722
Fax Number	:	561-276-7919

Provider Business Practice Location Address
First Line	:	601 N CONGRESS AVE STE 408
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-4640
Country	:	US
Telephone Number	:	561-276-1722
Fax Number	:	561-276-7919

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	NNACHI L OKO
Credential	:	MD
Telephone Number	:	561-276-1722

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	08/09/2010

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