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General NPI Number Information
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NPI Number | 1851013684
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Entity Type | Organization
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Legal Business Name | HOMESTEAD UROLOGY AT KEYS
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 103400 OVERSEAS HWY
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City | KEY LARGO
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State | FL
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Zip | 33037-2834
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Country | US
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Telephone | 954-854-9429
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Fax | 954-488-2176
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Provider Business Mailing Address
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Address Line | 103400 OVERSEAS HWY
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City | KEY LARGO
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State | FL
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Zip | 33037-2834
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Country | US
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Telephone | 954-854-9429
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Fax | 954-488-2176
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Authorized Official
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Title or Position | OWNER
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Name | DONGHUA XIE
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Credential | MD, PHD
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Telephone | 954-854-9429
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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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