Provider Demographics
NPI:1376016568
Name:ADVANCED INNOVATIVE UROLOGY PA
Entity type:Organization
Organization Name:ADVANCED INNOVATIVE UROLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:N
Authorized Official - Last Name:BERNSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-716-7455
Mailing Address - Street 1:4737 N OCEAN DR STE 103
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE BY THE SEA
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2920
Mailing Address - Country:US
Mailing Address - Phone:561-716-7455
Mailing Address - Fax:
Practice Address - Street 1:4737 N OCEAN DR STE 103
Practice Address - Street 2:
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-2920
Practice Address - Country:US
Practice Address - Phone:561-716-7455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty