MEDICARE: ULTRASOUND CARE SPECIALIST, 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
1	2471S1302X	Sonography Radiologic Technologist
2	261QR0208X	Mobile Radiology Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922442144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTRASOUND CARE SPECIALIST, INC.

Provider Business Mailing Address
First Line	:	2043 DERBY GLEN DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-8029
Country	:	US
Telephone Number	:	407-729-2594
Fax Number	:

Provider Business Practice Location Address
First Line	:	8803 FUTURES DR
Second Line	:	SUITE 12 - UNIT #105
City	:	ORLANDO
State	:	FL
Zip	:	32819-9076
Country	:	US
Telephone Number	:	407-729-2594
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. GRISEL AQUINO
Credential	:	R.D.M.S. OB/GYN
Telephone Number	:	407-729-2594

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	09/11/2014

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