MEDICARE: FLORIDA UROLOGY ONCOLOGY AND UROGYNECOLOGY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207VX0201X	Gynecologic Oncology Physician
2	2086X0206X	Surgical Oncology Physician
3	208800000X	Urology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689970972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA UROLOGY ONCOLOGY AND UROGYNECOLOGY LLC

Provider Business Mailing Address
First Line	:	215 LITHIA PINECREST RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-5307
Country	:	US
Telephone Number	:	813-681-2300
Fax Number	:	813-681-2330

Provider Business Practice Location Address
First Line	:	215 LITHIA PINECREST RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-5307
Country	:	US
Telephone Number	:	813-681-2300
Fax Number	:	813-681-2330

Authorized Official
Title or Position	:	OWNER/MD
Name	:	DR. JAMIL U REHMAN
Credential	:	M.D.
Telephone Number	:	813-681-2300

Provider Enumeration Date	:	02/03/2011
Last Update Date	:	02/03/2011

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