Provider Demographics
NPI:1467130294
Name:BOWER UROLOGY LLC
Entity Type:Organization
Organization Name:BOWER UROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:CUKRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-993-0422
Mailing Address - Street 1:1941 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5535
Mailing Address - Country:US
Mailing Address - Phone:772-340-6777
Mailing Address - Fax:772-236-3002
Practice Address - Street 1:1941 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5535
Practice Address - Country:US
Practice Address - Phone:772-340-6777
Practice Address - Fax:772-236-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty