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General NPI Number Information
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NPI Number | 1144270109
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Entity Type | Organization
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Legal Business Name | SOUTH COUNTY UROLOGY PA
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 08/16/2011
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Provider Practice Location Address
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Address Line | 5258 LINTON BLVD SUITE 203
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6540
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Country | US
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Telephone | 561-495-7570
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Fax | 561-496-7074
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Provider Business Mailing Address
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Address Line | 5258 LINTON BLVD SUITE 203
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6540
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Country | US
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Telephone | 561-495-7570
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Fax | 561-496-7074
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Authorized Official
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Title or Position | OWNER
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Name | MARK D ZIFFER
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Credential | MD
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Telephone | 561-495-7570
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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 | ME 46004
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License Number State | FL
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