MEDICARE: OK UROLOGY PLLC

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

General Provider Information

NPI Number	:	1841145257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OK UROLOGY PLLC

Provider Business Mailing Address
First Line	:	3246 COVE BEND DR STE 8
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3246 COVE BEND DR STE 8
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2752
Country	:	US
Telephone Number	:	813-228-0012
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. OMER KINEISH
Credential	:	MD
Telephone Number	:	813-228-0012

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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