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General NPI Number Information
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NPI Number | 1710965173
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Entity Type | Organization
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Legal Business Name | URO-MEDIX, INC.
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 8890 W OAKLAND PARK BLVD SUITE 304
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City | SUNRISE
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State | FL
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Zip | 33351-7235
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Country | US
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Telephone | 954-748-4771
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Fax | 954-748-6755
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Provider Business Mailing Address
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Address Line | 8890 W OAKLAND PARK BLVD SUITE 304
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City | SUNRISE
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State | FL
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Zip | 33351-7235
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Country | US
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Telephone | 954-748-4771
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Fax | 954-748-6755
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. RICHARD B. ANTOSEK
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Credential | D.O.
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Telephone | 954-748-4771
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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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