Provider Demographics
NPI:1386402493
Name:UROLOGY MEDICAL SPECIALISTS, PA
Entity type:Organization
Organization Name:UROLOGY MEDICAL SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-943-1133
Mailing Address - Street 1:5258 LINTON BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6529
Mailing Address - Country:US
Mailing Address - Phone:561-495-7570
Mailing Address - Fax:561-496-7074
Practice Address - Street 1:1930 NE 47TH ST STE 308
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-7729
Practice Address - Country:US
Practice Address - Phone:954-943-1133
Practice Address - Fax:954-783-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty