Provider Demographics
NPI:1902153570
Name:MICHELLE UGALDE
Entity Type:Organization
Organization Name:MICHELLE UGALDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT NURSING CONTRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:UGALDE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:561-329-9656
Mailing Address - Street 1:4792 VICTORIA CIR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7841
Mailing Address - Country:US
Mailing Address - Phone:561-329-9656
Mailing Address - Fax:561-478-2818
Practice Address - Street 1:4792 VICTORIA CIR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-7841
Practice Address - Country:US
Practice Address - Phone:561-329-9656
Practice Address - Fax:561-478-2818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health