Provider Demographics
NPI:1518402627
Name:URHEALTH
Entity Type:Organization
Organization Name:URHEALTH
Other - Org Name:URBAN HEALTH AND WELLNESS
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTEWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-454-8798
Mailing Address - Street 1:5931 NW 173RD DR
Mailing Address - Street 2:SUITE #1
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5106
Mailing Address - Country:US
Mailing Address - Phone:305-454-8798
Mailing Address - Fax:
Practice Address - Street 1:5931 NW 173RD DR
Practice Address - Street 2:SUITE #1
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5106
Practice Address - Country:US
Practice Address - Phone:305-454-8798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty