Healthcare Provider Details

I. General information

NPI: 1326079591
Provider Name (Legal Business Name): UROLOGY ASSOCIATES OF NORTH CENTRAL FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1179 NW 64TH TER
GAINESVILLE FL
32605-4218
US

IV. Provider business mailing address

1179 NW 64TH TER
GAINESVILLE FL
32605-4218
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-5400
  • Fax: 352-333-5404
Mailing address:
  • Phone: 352-333-5400
  • Fax: 352-333-5404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0062982
License Number StateFL

VIII. Authorized Official

Name: DR. MARTIN NEIL RIFKIN
Title or Position: PRESIDENT
Credential: MD
Phone: 352-333-5400