Healthcare Provider Details

I. General information

NPI: 1851264659
Provider Name (Legal Business Name): STREAMLINE UROLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 NW 56TH TER STE D
GAINESVILLE FL
32605-6418
US

IV. Provider business mailing address

817 NW 56TH TER STE D
GAINESVILLE FL
32605-6418
US

V. Phone/Fax

Practice location:
  • Phone: 352-234-3050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEFAN MANN
Title or Position: PRESIDENT
Credential: MD
Phone: 352-234-3050