Provider Demographics
NPI:1952493280
Name:FLORIDA UROLOGY PHYSICIANS
Entity Type:Organization
Organization Name:FLORIDA UROLOGY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-689-8800
Mailing Address - Street 1:7451 GLADIOLUS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5193
Mailing Address - Country:US
Mailing Address - Phone:239-689-8800
Mailing Address - Fax:239-939-7774
Practice Address - Street 1:7451 GLADIOLUS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5193
Practice Address - Country:US
Practice Address - Phone:239-689-8800
Practice Address - Fax:239-939-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3884Medicare ID - Type Unspecified