Provider Demographics
NPI:1427381953
Name:PLANT CITY UROLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:PLANT CITY UROLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALIM
Authorized Official - Middle Name:K
Authorized Official - Last Name:AFRIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-719-6920
Mailing Address - Street 1:207 N PLANT AVE
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4731
Mailing Address - Country:US
Mailing Address - Phone:813-719-6920
Mailing Address - Fax:813-719-6398
Practice Address - Street 1:207 N PLANT AVE
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4731
Practice Address - Country:US
Practice Address - Phone:813-719-6920
Practice Address - Fax:813-719-6398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073995174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDH315AMedicare PIN