Provider Demographics
NPI:1164210233
Name:MEDICAL DOCTORS OFFICE LLC
Entity type:Organization
Organization Name:MEDICAL DOCTORS OFFICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:USHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-446-7400
Mailing Address - Street 1:400 OCEAN TRAIL WAY APT 1405
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5528
Mailing Address - Country:US
Mailing Address - Phone:516-446-7400
Mailing Address - Fax:
Practice Address - Street 1:725 N HIGHWAY A1A STE D101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-9513
Practice Address - Country:US
Practice Address - Phone:516-446-7400
Practice Address - Fax:561-879-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty