=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386824514
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSS URWIN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/05/2007
-----------------------------------------------------
Last Update Date | 01/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 S FEDERAL HWY SUITE 200
-----------------------------------------------------
City | POMPANO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33062-7500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-784-5140
-----------------------------------------------------
Fax | 954-784-3027
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5267
-----------------------------------------------------
City | LIGHTHOUSE POINT
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33074-5267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-784-5140
-----------------------------------------------------
Fax | 954-784-3027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085N0700X
-----------------------------------------------------
Taxonomy Name | Neuroradiology Physician
-----------------------------------------------------
License Number | ME77663
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------