Organization
UNIVERSAL SA CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX PONTIGO (PRESIDENT)
(305) 513-5752
Entity
Organization
Contact information
Practice address
2520 SW 22ND ST, SUITE 2-070, CORAL GABLES, FL 33145-3438
(305) 513-5752
Mailing address
2520 SW 22ND ST, SUITE 2-070, CORAL GABLES, FL 33145-3438
(305) 513-5752
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
—
FL
305R00000X
Preferred Provider Organization
Primary
—
FL
Other
Enumeration date
01/23/2009
Last updated
01/23/2009
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