MEDICARE: URGIMED WEST LLC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1326980921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URGIMED WEST LLC

Provider Business Mailing Address
First Line	:	3242 PARKSIDE CENTER CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-0907
Country	:	US
Telephone Number	:	813-819-7974
Fax Number	:	888-947-4627

Provider Business Practice Location Address
First Line	:	3242 PARKSIDE CENTER CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-0907
Country	:	US
Telephone Number	:	813-819-7974
Fax Number	:	888-947-4627

Authorized Official
Title or Position	:	MANAGER
Name	:	IRINA SONAYAN
Credential	:
Telephone Number	:	321-888-0733

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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