| Organization Name: | AGNES UBANI INC |
| NPI Number: | 1134302748 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AGNES UBANI (PHYSICIAN) |
| Mailing Address: | 10320 N 56th St Suite 120 Temple Terrace |
| State: | FL US |
| Postal Code: | 336174071 |
| Phone Number: | 8133417900 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2007 |
| NPI Last Update Date: | 12/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | ME 84332 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |