Provider Demographics
NPI:1003021296
Name:MADORSKY, PINON, BRUCK & MENNIE UROLOGY CENTER OF SOUTH FLORIDA PA
Entity type:Organization
Organization Name:MADORSKY, PINON, BRUCK & MENNIE UROLOGY CENTER OF SOUTH FLORIDA PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DELCARMEN
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-270-6010
Mailing Address - Street 1:7400 SW 87TH AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5458
Mailing Address - Country:US
Mailing Address - Phone:305-270-6010
Mailing Address - Fax:305-598-7754
Practice Address - Street 1:7400 SW 87TH AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5458
Practice Address - Country:US
Practice Address - Phone:305-270-6010
Practice Address - Fax:305-598-7754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty