Provider Demographics
NPI:1477329688
Name:INNOVATIVE UROLOGY OF ORLANDO
Entity Type:Organization
Organization Name:INNOVATIVE UROLOGY OF ORLANDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:PARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-721-8216
Mailing Address - Street 1:10125 W COLONIAL DR STE 218
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4200
Mailing Address - Country:US
Mailing Address - Phone:689-212-5317
Mailing Address - Fax:
Practice Address - Street 1:10125 W COLONIAL DR STE 218
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4200
Practice Address - Country:US
Practice Address - Phone:407-723-0041
Practice Address - Fax:407-723-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty