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General NPI Number Information
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NPI Number | 1083984744
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Entity Type | Organization
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Legal Business Name | SFM UROLOGY II
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 3347 STATE ROAD 7 SUITE 101
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City | WELLINGTON
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State | FL
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Zip | 33449-8095
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Country | US
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Telephone | 561-790-2111
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Fax | 561-790-0893
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Provider Business Mailing Address
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Address Line | 3343 STATE ROAD 7
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City | WELLINGTON
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State | FL
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Zip | 33449-8002
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Country | US
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Telephone | 561-795-9845
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Fax | 561-721-4188
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | RAVI PATEL
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Credential |
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Telephone | 561-795-9845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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