NPIMap

Advanced Urology Institute LLC

Organization Active NPI Community/Retail Pharmacy · South Pasadena, FL

NPI 1003437732 · NPPES record last updated Apr 2, 2024

Key facts

NPI
1003437732
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
ADVANCED UROLOGY INSTITUTE LLC
Practice address
1401 Pasadena Ave S Ste 5
South Pasadena, FL 33707-3715
Phone
(727) 241-4994
Fax
(727) 241-5090
NPI assigned
May 5, 2020
Organization subpart
No

Authorized official

Name
Rolando Rivera, MD NPI 1295786093
Title
Authorized Official
Phone
(352) 205-8981

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Practitioners 152

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 152

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230224001348 FL DME Supplier - Physician - Urology 2163653585 Practice locations: Naples, FL

National Provider Directory

Tax ID family
Advanced Urology Ins LLC (31 organizations share this tax ID)

Locations

1401 Pasadena Ave S
Ste 5
South Pasadena, FL 33707
Phone (727) 241-4994

Networks

  • Freedom Health HMO Network
    Plans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO Network
    Plans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

1401 Pasadena Ave S Ste 5
South Pasadena, FL 33707-3715

Mailing address

12109 County Road 103
Oxford, FL 34484-2951

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Other providers in South Pasadena, FL

All providers in South Pasadena, FL · Community/Retail Pharmacy in Florida

Sources for this page

Verify at the official NPI Registry.