Basic Information
Provider Information
NPI: 1497365829
EntityType: 2
ReplacementNPI:  
OrganizationName: UPPERLINE HEALTHCARE, PC
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Mailing Information
Address1: 102 WOODMONT BLVD STE 450
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372055202
CountryCode: US
TelephoneNumber: 8443863338
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Practice Location
Address1: 6000 TURKEY LAKE RD STE 108
Address2:  
City: ORLANDO
State: FL
PostalCode: 328194205
CountryCode: US
TelephoneNumber: 4074471234
FaxNumber: 4073630593
Other Information
ProviderEnumerationDate: 07/31/2020
LastUpdateDate: 02/02/2021
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AuthorizedOfficialLastName: THORPE
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName: VANDIVER
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 2058073009
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 02/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213ES0131X  Y193200000X MULTI-SPECIALTY GROUPPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery

No ID Information.


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