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NPI Code Detail

MEDICARE: PINELLAS UROLOGY, INC.

MEDICARE: PINELLAS UROLOGY, 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
1208800000XUrology Physician

General Provider Information

NPI Number : 1568426682
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINELLAS UROLOGY, INC.
Provider Business Mailing Address
First Line : 5747 38TH AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33710-1925
Country : US
Telephone Number : 727-381-8667
Fax Number : 727-345-1951
Provider Business Practice Location Address
First Line : 5747 38TH AVE N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33710-1925
Country : US
Telephone Number : 727-381-8667
Fax Number : 727-345-1951
Authorized Official
Title or Position : VICE PRESIDENT
Name : SEAN P HERON
Credential : M.D.
Telephone Number : 727-381-8667
Provider Enumeration Date : 04/14/2006
Last Update Date : 08/22/2020

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Directions to “PINELLAS UROLOGY, INC. ” Practice Location

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