Basic Information
| Provider Information | |||||||||
| NPI: | 1831642446 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UCP OF CENTRAL FLORIDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1221 W COLONIAL DR | ||||||||
| Address2: | SUITE,300 | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328047163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078523347 | ||||||||
| FaxNumber: | 4074201556 | ||||||||
| Practice Location | |||||||||
| Address1: | 448 W DONEGAN AVE | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347412335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078523300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2016 | ||||||||
| LastUpdateDate: | 07/31/2016 | ||||||||
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| AuthorizedOfficialLastName: | PADILLA | ||||||||
| AuthorizedOfficialFirstName: | ROSINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | RISK MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4078523347 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251C00000X | OT14539 | FL | Y | Agencies | Day Training, Developmentally Disabled Services |
No ID Information.