Provider Demographics
NPI:1528367463
Name:CENTRAL FLORIDA UROLOGY SPECIALISTS
Entity Type:Organization
Organization Name:CENTRAL FLORIDA UROLOGY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:TAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-351-1313
Mailing Address - Street 1:12109 CR 103
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-2967
Mailing Address - Country:US
Mailing Address - Phone:352-240-7448
Mailing Address - Fax:352-391-6498
Practice Address - Street 1:1934 SALK AVE
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4310
Practice Address - Country:US
Practice Address - Phone:352-742-2201
Practice Address - Fax:352-742-2226
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL FLORIDA UROLOGY SPECIALISTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-17
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBC700Medicare PIN
FL6219110009Medicare NSC