Provider Demographics
NPI:1952854853
Name:UROLOGY SPECIALIST GROUP LLC
Entity Type:Organization
Organization Name:UROLOGY SPECIALIST GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMEYDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-822-7227
Mailing Address - Street 1:2140 W 68TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1815
Mailing Address - Country:US
Mailing Address - Phone:305-822-7227
Mailing Address - Fax:786-431-2075
Practice Address - Street 1:2140 W 68TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1815
Practice Address - Country:US
Practice Address - Phone:305-822-7227
Practice Address - Fax:786-431-2075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty