| Ullan Medical Office Inc | |
|
454 Nw 22nd Ave Ste 204 Miami FL 33125-3354 | |
| (305) 200-6008 | |
| Not Available |
| Full Name | Ullan Medical Office Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 454 Nw 22nd Ave Ste 204, Miami, Florida |
| Authorized Official Name and Position | Eduardo M Interian (CEO) |
| Authorized Official Contact | 3052006008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ullan Medical Office Inc 454 Nw 22nd Ave Ste 204 Miami FL 33125-3354 Ph: (305) 200-6008 | Ullan Medical Office Inc 454 Nw 22nd Ave Ste 204 Miami FL 33125-3354 Ph: (305) 200-6008 |
| NPI Number | 1669356184 |
|---|---|
| Provider Enumeration Date | 08/05/2025 |
| Last Update Date | 08/28/2025 |
| Certification Date | 08/28/2025 |
| Medicare PECOS PAC ID | 9537662952 |
|---|---|
| Medicare Enrollment ID | O20250911003776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669356184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
| Provider Name | Elizabeth Gonzalez Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558038299 PECOS PAC ID: 8325480163 Enrollment ID: I20240524002691 |
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