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General NPI Number Information
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NPI Number | 1740315449
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Entity Type | Organization
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Legal Business Name | PALMS UROPATHOLOGY PA
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 6043 WINTHROP COMMERCE AVE
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City | RIVERVIEW
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State | FL
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Zip | 33569-4207
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Country | US
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Telephone | 813-649-8026
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Fax | 813-425-5760
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Provider Business Mailing Address
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Address Line | 9225 BAY PLAZA BLVD SUITE # 418
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City | TAMPA
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State | FL
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Zip | 33619-4466
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Country | US
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Telephone | 813-649-8026
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Fax | 813-425-5760
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | FARUK AYDIN
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Credential | M.D.
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Telephone | 813-649-8026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 800001938
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License Number State | FL
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