1033461090 NPI number — UROLOGY GROUP OF FLORIDA LLC

Table of content: MR. THOMAS PRESSLY CASTLES JR. (NPI 1619214038)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033461090 NPI number — UROLOGY GROUP OF FLORIDA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UROLOGY GROUP OF FLORIDA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033461090
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5350 W ATLANTIC AVE
Provider Second Line Business Mailing Address:
102
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33484-8112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-496-4444
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1411 N FLAGLER DR
Provider Second Line Business Practice Location Address:
SUITE 5300
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33401-3404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-833-5594
Provider Business Practice Location Address Fax Number:
561-833-0017
Provider Enumeration Date:
10/15/2012

Additional Information

Authorized Official

Authorized Official Last Name:
YORE
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-496-4444

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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