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General NPI Number Information
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NPI Number | 1821060401
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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 | 3475 S SUNCOAST BLVD
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City | HOMOSASSA
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State | FL
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Zip | 34448-2322
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Country | US
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Telephone | 352-628-7671
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Fax | 352-628-9893
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Provider Business Mailing Address
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Address Line | PO BOX 3087
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City | HOMOSASSA SPRINGS
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State | FL
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Zip | 34447-3087
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Country | US
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Telephone | 352-628-7671
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Fax | 352-628-9893
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. PARESH DESAI
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Credential | M.D.
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Telephone | 352-628-7671
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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 | 10D0272423
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License Number State | FL
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