Provider Demographics
NPI:1285913848
Name:ALL WOMEN UROLOGY PA
Entity type:Organization
Organization Name:ALL WOMEN UROLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOBBY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-795-1234
Mailing Address - Street 1:10115 FOREST HILL BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6178
Mailing Address - Country:US
Mailing Address - Phone:561-795-1234
Mailing Address - Fax:561-800-1006
Practice Address - Street 1:10115 FOREST HILL BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6178
Practice Address - Country:US
Practice Address - Phone:561-795-1234
Practice Address - Fax:561-800-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8529208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG51456Medicare UPIN