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General NPI Number Information
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NPI Number | 1174471130
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Entity Type | Organization
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Legal Business Name | ADVANCED UROLOGY INSTITUTE LLC
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 3730 7TH TER STE 204
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City | VERO BEACH
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State | FL
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Zip | 32960-7324
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Country | US
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Telephone | 352-350-8282
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Fax |
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Provider Business Mailing Address
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Address Line | 3730 7TH TER STE 204
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City | VERO BEACH
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State | FL
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Zip | 32960-7324
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Country | US
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Telephone | 352-350-8282
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JON MACKLER
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Credential |
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Telephone | 352-350-8282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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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