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General NPI Number Information
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NPI Number | 1174584619
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Entity Type | Individual
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Provider Name | YURI E REINBERG MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 04/19/2019
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Provider Practice Location Address
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Address Line | 807 CHILDRENS WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8426
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Country | US
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Telephone | 904-697-3600
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Fax | 904-697-3927
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Provider Business Mailing Address
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Address Line | 2530 CHICAGO AVE #550
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-4289
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Country | US
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Telephone | 612-813-8000
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Fax | 612-813-8005
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 30855
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | ME138919
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License Number State | FL
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