Healthcare Provider Details

I. General information

NPI: 1316369762
Provider Name (Legal Business Name): DR. FLORIN URLEA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2014
Last Update Date: 01/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6645 W PEORIA AVE
GLENDALE AZ
85302-1011
US

IV. Provider business mailing address

6645 W PEORIA AVE
GLENDALE AZ
85302-1011
US

V. Phone/Fax

Practice location:
  • Phone: 623-773-2954
  • Fax: 623-773-2956
Mailing address:
  • Phone: 623-773-2954
  • Fax: 623-773-2956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12963
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: