Provider Demographics
NPI:1336481969
Name:UROLOGY SPECIALTY CARE OF MIAMI, LLC
Entity Type:Organization
Organization Name:UROLOGY SPECIALTY CARE OF MIAMI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:COSME
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-275-5525
Mailing Address - Street 1:3225 AVIATION AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7600 SW 87TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3601
Practice Address - Country:US
Practice Address - Phone:305-725-5525
Practice Address - Fax:305-275-0662
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VITALMD GROUP HOLDING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty