Provider Demographics
NPI:1972741890
Name:ADVANCED UROLOGY INSTITUTE, LLC
Entity Type:Organization
Organization Name:ADVANCED UROLOGY INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
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:352-391-6494
Mailing Address - Fax:352-391-6498
Practice Address - Street 1:2301 SE 3RD AVE
Practice Address - Street 2:BLDG 100 STE A
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5114
Practice Address - Country:US
Practice Address - Phone:352-351-0029
Practice Address - Fax:352-840-9977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED UROLOGY INSTITUTE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-30
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6219110005Medicare NSC
FLHS558BMedicare PIN
FLHS558AMedicare PIN