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General NPI Number Information
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NPI Number | 1962489278
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Entity Type | Organization
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Legal Business Name | PENSACOLA UROLOGY, PA
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1717 N E ST SUITE 430
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City | PENSACOLA
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State | FL
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Zip | 32501-6339
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Country | US
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Telephone | 850-444-4707
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Fax | 850-432-2532
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Provider Business Mailing Address
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Address Line | 1717 N E ST SUITE 430
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City | PENSACOLA
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State | FL
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Zip | 32501-6339
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Country | US
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Telephone | 850-444-4707
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Fax | 850-432-2532
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Authorized Official
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Title or Position | INSURANCE & BILLING SUPERVISOR
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Name | MS. RONDA MICHELLE BOND
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Credential | CMA
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Telephone | 850-444-4707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | FL
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