Provider Demographics
NPI:1063644631
Name:UROLOGICAL CENTER LLC
Entity Type:Organization
Organization Name:UROLOGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCROGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-630-6277
Mailing Address - Street 1:1625 SE 3RD AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2521
Mailing Address - Country:US
Mailing Address - Phone:954-355-5135
Mailing Address - Fax:
Practice Address - Street 1:1625 SE 3RD AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-355-5135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QL0400XAmbulatory Health Care FacilitiesClinic/CenterLithotripsy
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty