Provider Demographics
NPI:1033265392
Name:FLORIDA UROLOGY GROUP, P.A.
Entity Type:Organization
Organization Name:FLORIDA UROLOGY GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLO PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:407-839-1155
Mailing Address - Street 1:2690 ORANGE PEEL COURT
Mailing Address - Street 2:ATTN: LEE B. CECIL, CPCS
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806
Mailing Address - Country:US
Mailing Address - Phone:407-896-3055
Mailing Address - Fax:407-826-1103
Practice Address - Street 1:2690 ORANGE PEEL COURT
Practice Address - Street 2:ATTN: LEE B. CECIL, CPCS
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:407-896-3055
Practice Address - Fax:407-826-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58902Medicare UPIN