Organization
SUNRISE MEDICAL GROUP INC
Active
Parent organization
UNIVERSAL MEDICAL CONCEPTS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSAL MEDICAL CONCEPTS INC
Authorized official
GIOVANNE ZYGALA (CREDENTIALING MANAGER)
(954) 956-1966
Entity
Organization
Contact information
Practice address
4925 SHERIDAN ST, 200, HOLLYWOOD, FL 33021-2829
(954) 981-3850
(954) 981-3889
Mailing address
6245 N FEDERAL HWY, SUITE 300, FORT LAUDERDALE, FL 33308-1998
(954) 956-1966
(954) 745-0501
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258676200
—
FL
05
—
258676201
—
FL
05
—
258676202
—
FL
05
—
258676203
—
FL
05
—
258676204
—
FL
05
—
258676205
—
FL
05
—
258676206
—
FL
Enumeration date
05/11/2006
Last updated
12/15/2009
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