Provider Demographics
NPI:1295751741
Name:ADVANCED UROLOGY OF CENTRAL FLORIDA, PA
Entity type:Organization
Organization Name:ADVANCED UROLOGY OF CENTRAL FLORIDA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALDEN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:REINE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:407-296-8082
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:SUITE 382
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3498
Mailing Address - Country:US
Mailing Address - Phone:407-296-8082
Mailing Address - Fax:407-296-8083
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:SUITE 382
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3498
Practice Address - Country:US
Practice Address - Phone:407-296-8082
Practice Address - Fax:407-296-8083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77354208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty