Provider Demographics
NPI:1669403739
Name:UROLOGY CONSULTANTS, INC.
Entity type:Organization
Organization Name:UROLOGY CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-785-6011
Mailing Address - Street 1:33920 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 241
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2654
Mailing Address - Country:US
Mailing Address - Phone:727-785-6011
Mailing Address - Fax:727-787-6951
Practice Address - Street 1:33920 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 241
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2654
Practice Address - Country:US
Practice Address - Phone:727-785-6011
Practice Address - Fax:727-787-6951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21460CMedicare PIN
FL21460Medicare PIN