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General NPI Number Information
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NPI Number | 1619949294
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Entity Type | Organization
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Legal Business Name | CITRUS UROLOGY ASSOCIATES P A
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 08/15/2008
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Provider Practice Location Address
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Address Line | 1210 WATERMAN WAY
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City | TAVARES
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State | FL
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Zip | 32778-5229
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Country | US
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Telephone | 352-742-2201
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Fax | 352-742-2226
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Provider Business Mailing Address
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Address Line | 1210 WATERMAN WAY
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City | TAVARES
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State | FL
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Zip | 32778-5229
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Country | US
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Telephone | 352-742-2201
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Fax | 352-742-2226
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CHARLES K CARTWRIGHT
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Credential | M.D.
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Telephone | 352-742-2201
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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 | 10D1018775
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License Number State | FL
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