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General NPI Number Information
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NPI Number | 1467118745
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Entity Type | Organization
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Legal Business Name | UROLOGY PROFESSIONALS OF SOUTH FLORIDA LLC
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 3939 HOLLYWOOD BLVD STE 3A
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6736
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Country | US
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Telephone | 954-961-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 WASHINGTON ST STE 104
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8291
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Country | US
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Telephone | 305-836-1090
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Fax | 305-836-1199
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Authorized Official
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Title or Position | MGMR
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Name | MATTHEW KOBINA HASFORD
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Credential | MD
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Telephone | 305-836-1090
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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 |
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License Number State |
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