Provider Demographics
NPI:1528471000
Name:UNIVERSITY ATHLETIC ASSOCIATION
Entity type:Organization
Organization Name:UNIVERSITY ATHLETIC ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ATHLETIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WARD
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-375-4683
Mailing Address - Street 1:4752 SW 88TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4145
Mailing Address - Country:US
Mailing Address - Phone:352-375-4683
Mailing Address - Fax:352-377-8483
Practice Address - Street 1:290 WOODLAWN DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-1949
Practice Address - Country:US
Practice Address - Phone:352-375-4683
Practice Address - Fax:352-377-8483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL3432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty