Provider Demographics
NPI:1023197191
Name:WEST FLORIDA UROLOGY PLC
Entity Type:Organization
Organization Name:WEST FLORIDA UROLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-771-0600
Mailing Address - Street 1:35095 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2686
Mailing Address - Country:US
Mailing Address - Phone:727-771-0600
Mailing Address - Fax:727-781-9666
Practice Address - Street 1:35095 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 202
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2686
Practice Address - Country:US
Practice Address - Phone:727-771-0600
Practice Address - Fax:727-781-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty