Healthcare Provider Details

I. General information

NPI: 1427023829
Provider Name (Legal Business Name): CENTRAL FLORIDA UROLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4106 W LAKE MARY BLVD STE 215
LAKE MARY FL
32746-3344
US

IV. Provider business mailing address

4106 W LAKE MARY BLVD STE 215
LAKE MARY FL
32746-3344
US

V. Phone/Fax

Practice location:
  • Phone: 407-332-7700
  • Fax: 321-275-0344
Mailing address:
  • Phone: 407-332-7700
  • Fax: 321-275-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MICHAEL D FRIEDMAN
Title or Position: PHYSICIAN
Credential: MD
Phone: 407-332-7700