MEDICARE: PLANT CITY UROLOGY ASSOCIATES INC

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	174400000X	Specialist	ME0073995	FL

General Provider Information

NPI Number	:	1427381953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANT CITY UROLOGY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	207 N PLANT AVE
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4731
Country	:	US
Telephone Number	:	813-719-6920
Fax Number	:	813-719-6398

Provider Business Practice Location Address
First Line	:	207 N PLANT AVE
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4731
Country	:	US
Telephone Number	:	813-719-6920
Fax Number	:	813-719-6398

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SALIM K AFRIDI
Credential	:	M.D.
Telephone Number	:	813-719-6920

Provider Enumeration Date	:	09/16/2009
Last Update Date	:	04/14/2011

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