Provider Demographics
NPI:1548969280
Name:UNITED METABOLIC TREATMENT CENTERS, LLC
Entity type:Organization
Organization Name:UNITED METABOLIC TREATMENT CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLIVE, JR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-424-3830
Mailing Address - Street 1:808 LANSDEN COURT
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689
Mailing Address - Country:US
Mailing Address - Phone:727-424-3830
Mailing Address - Fax:
Practice Address - Street 1:1200 SOUTH PINELLAS AVE.
Practice Address - Street 2:SUITE 1
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689
Practice Address - Country:US
Practice Address - Phone:727-682-5917
Practice Address - Fax:727-334-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty