MEDICARE: NEW TAMPA UROLOGY P A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	ME68367	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003840091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW TAMPA UROLOGY P A

Provider Business Mailing Address
First Line	:	5332 PRIMROSE LAKE CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3589
Country	:	US
Telephone Number	:	813-558-9091
Fax Number	:	813-866-3948

Provider Business Practice Location Address
First Line	:	5332 PRIMROSE LAKE CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3589
Country	:	US
Telephone Number	:	813-558-9091
Fax Number	:	813-866-3948

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. CARLA WILLIAMSON STARLING
Credential	:
Telephone Number	:	813-558-9091

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	04/29/2008

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Directions to “NEW TAMPA UROLOGY P A ” Practice Location

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