Provider Demographics
NPI:1982150934
Name:UF
Entity type:Organization
Organization Name:UF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-273-5688
Mailing Address - Street 1:1333 NW 117TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-0422
Mailing Address - Country:US
Mailing Address - Phone:352-226-4651
Mailing Address - Fax:
Practice Address - Street 1:1395 CENTER DR # D8-18
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0406
Practice Address - Country:US
Practice Address - Phone:352-273-7755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial RadiologyGroup - Single Specialty