Basic Information
| Provider Information | |||||||||
| NPI: | 1669042461 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UPPERLINE HEALTHCARE, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 WOODMONT BLVD STE 450 | ||||||||
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| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372055202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072195402 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2111 GLENWOOD DR STE 208 | ||||||||
| Address2: | |||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327923328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076471550 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2021 | ||||||||
| LastUpdateDate: | 06/25/2021 | ||||||||
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| AuthorizedOfficialLastName: | THORPE | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | VANDIVER | ||||||||
| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 2058073009 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.