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General NPI Number Information
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NPI Number | 1346306636
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Entity Type | Organization
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Legal Business Name | UROLOGY CENTER OF CENTRAL FLORIDA
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 3208 HILLSDALE LN.
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City | KISSIMMEE
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State | FL
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Zip | 34741-7562
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Country | US
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Telephone | 407-846-2698
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Fax | 407-846-3261
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Provider Business Mailing Address
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Address Line | 3208 HILLSDALE LN.
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City | KISSIMMEE
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State | FL
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Zip | 34741-7562
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Country | US
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Telephone | 407-846-2698
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Fax | 407-846-3261
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. MICHAEL WILLIAM MCDONALD
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Credential | M.D.
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Telephone | 407-846-2698
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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 | ME94029
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License Number State | FL
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