J Craig Uecker MD PA

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

J CRAIG UECKER MD PA

Practice address

3449 Johnson St
Hollywood, FL 33021-5420

Phone

(954) 964-4113

Fax

(954) 963-8121

NPI assigned

Mar 19, 2012

Last updated

Jul 18, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Wanda Lynn Ditthardt

Title

Office Manager

Phone

(954) 964-4113

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1174898597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215420",
            "telephone_number": "954-964-4113",
            "fax_number": "954-963-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3449 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215420",
            "telephone_number": "954-964-4113",
            "fax_number": "954-963-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J CRAIG UECKER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "DITTHARDT",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-964-4113",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Thalia Izquierdo
• Lorraine Dee Dalisay Izquierdo, NP
• Naylen Izquierdo
• Wilson Izquierdo, M.D.
• Jessica L. Izyk, PT, DPT
• Israel Salvador Jacas Carvajal
• Kenya A'Leesha Alyxx Jack
• Jade Indira Jackson
• Tamara M Jackson
• Tiffany Chelan Jackson, MSN, RN

• Plastic and Reconstructive Surgery Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.