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General NPI Number Information
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NPI Number | 1003021296
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Entity Type | Organization
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Legal Business Name | MADORSKY, PINON, BRUCK & MENNIE UROLOGY CENTER OF SOUTH FLORIDA PA
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 7400 SW 87TH AVE SUITE 240
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City | MIAMI
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State | FL
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Zip | 33173-5458
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Country | US
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Telephone | 305-270-6010
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Fax | 305-598-7754
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Provider Business Mailing Address
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Address Line | 7400 SW 87TH AVE SUITE 240
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City | MIAMI
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State | FL
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Zip | 33173-5458
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Country | US
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Telephone | 305-270-6010
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Fax | 305-598-7754
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARIA DELCARMEN LOPEZ
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Credential |
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Telephone | 305-270-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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