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General NPI Number Information
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NPI Number | 1124448014
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Entity Type | Individual
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Provider Name | GINGER LYNN URBANIAK M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2014
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 13201 WALSINGHAM RD STE 200
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City | LARGO
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State | FL
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Zip | 33774-3515
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Country | US
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Telephone | 727-447-4536
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Fax | 727-442-1600
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Provider Business Mailing Address
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Address Line | 2111 DREW ST STE 200
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City | CLEARWATER
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State | FL
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Zip | 33765-3215
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Country | US
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Telephone | 727-447-4536
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Fax | 727-442-1600
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME126575
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License Number State | FL
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