Basic Information
| Provider Information | |||||||||
| NPI: | 1033265392 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLORIDA UROLOGY GROUP, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2690 ORANGE PEEL COURT | ||||||||
| Address2: | ATTN: LEE B. CECIL, CPCS | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078963055 | ||||||||
| FaxNumber: | 4078261103 | ||||||||
| Practice Location | |||||||||
| Address1: | 2690 ORANGE PEEL COURT | ||||||||
| Address2: | ATTN: LEE B. CECIL, CPCS | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078963055 | ||||||||
| FaxNumber: | 4078261103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 09/07/2011 | ||||||||
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| AuthorizedOfficialLastName: | HUNTER | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
| AuthorizedOfficialMiddleName: | T. | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLO PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 4078391155 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | II | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.