Provider Demographics
NPI:1164772935
Name:UROLOGY MEDICAL SPECIALISTS, PA
Entity Type:Organization
Organization Name:UROLOGY MEDICAL SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-943-1133
Mailing Address - Street 1:5258 LINTON BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6529
Mailing Address - Country:US
Mailing Address - Phone:561-495-7570
Mailing Address - Fax:561-496-7074
Practice Address - Street 1:4515 WILES RD STE 201
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-3414
Practice Address - Country:US
Practice Address - Phone:954-943-1133
Practice Address - Fax:954-783-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty