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NPI Code Detail

MEDICARE: UROLOGY CENTRAL PA

MEDICARE: UROLOGY CENTRAL PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianFL

General Provider Information

NPI Number : 1275717605
Entity Type Code : Organization
Provider Name (Legal Business Name) : UROLOGY CENTRAL PA
Provider Business Mailing Address
First Line : 10000 W COLONIAL DR
Second Line : STE 285
City : OCOEE
State : FL
Zip : 34761-3498
Country : US
Telephone Number : 407-298-6950
Fax Number : 407-578-2354
Provider Business Practice Location Address
First Line : 1135 LAKE AVE
Second Line :
City : CLERMONT
State : FL
Zip : 34711-3037
Country : US
Telephone Number : 407-298-6950
Fax Number : 407-578-2354
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. GHADA HILWA
Credential :
Telephone Number : 407-298-6950
Provider Enumeration Date : 12/20/2007
Last Update Date : 12/20/2007

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Directions to “UROLOGY CENTRAL PA ” Practice Location

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