Provider Demographics
NPI:1336323393
Name:UROGYNECOLOGY & PELVIC FLOOR SPECIALISTS, INC.
Entity type:Organization
Organization Name:UROGYNECOLOGY & PELVIC FLOOR SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPUTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-224-7662
Mailing Address - Street 1:745 W STATE ST
Mailing Address - Street 2:SUITE 550A
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1515
Mailing Address - Country:US
Mailing Address - Phone:614-224-7662
Mailing Address - Fax:614-224-7682
Practice Address - Street 1:745 W STATE ST
Practice Address - Street 2:SUITE 550A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1515
Practice Address - Country:US
Practice Address - Phone:614-224-7662
Practice Address - Fax:614-224-7682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065038207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHUR9305311Medicare PIN