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General NPI Number Information
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NPI Number | 1669604005
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Entity Type | Organization
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Legal Business Name | URBAN CARDIOLOGY LLC
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Dates
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Enumeration Date | 08/19/2009
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Last Update Date | 05/12/2010
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Provider Practice Location Address
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Address Line | 1800 SE 17TH STREET SUITE 700
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City | OCALA
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State | FL
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Zip | 34471-4191
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Country | US
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Telephone | 352-861-5634
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Fax | 352-387-0382
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Provider Business Mailing Address
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Address Line | PO BOX 850001 DEPT 0673
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City | ORLANDO
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State | FL
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Zip | 32885-0673
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Country | US
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Telephone | 352-861-5634
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Fax | 352-387-0382
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Authorized Official
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Title or Position | OWNER
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Name | PAUL URBAN
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Credential | MD
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Telephone | 352-861-5634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9184663
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME42058
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License Number State | FL
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