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General NPI Number Information
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NPI Number | 1841474228
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Entity Type | Organization
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Legal Business Name | ADVANCED UROLOGY INSTITUTE, LLC
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 1775 E BAY DR
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City | LARGO
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State | FL
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Zip | 33771-2213
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Country | US
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Telephone | 727-441-1508
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Fax | 727-443-7780
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Provider Business Mailing Address
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Address Line | 12109 COUNTRY ROAD 103
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City | OXFORD
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State | FL
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Zip | 34484-2951
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Country | US
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Telephone | 352-205-8981
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Fax | 727-443-7780
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT SELLINGER
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Credential | MD
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Telephone | 352-205-8981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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