Healthcare Provider Details

I. General information

NPI: 1841106390
Provider Name (Legal Business Name): STREAMLINE UROLOGY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 THOMAS JOHNSON DR STE 102
FREDERICK MD
21702-4379
US

IV. Provider business mailing address

6119 FIELDCREST DR
FREDERICK MD
21701-5809
US

V. Phone/Fax

Practice location:
  • Phone: 301-606-0551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FERNANDINO VILSON
Title or Position: OWNER/UROLOGIST
Credential: MD, MBA
Phone: 443-684-4185