Provider Demographics
NPI:1699316760
Name:DOCTOR UNITED GROUP INC
Entity type:Organization
Organization Name:DOCTOR UNITED GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-206-6196
Mailing Address - Street 1:2150 W 76TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1882
Mailing Address - Country:US
Mailing Address - Phone:877-384-6337
Mailing Address - Fax:
Practice Address - Street 1:3300 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-8011
Practice Address - Country:US
Practice Address - Phone:866-745-8049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center