Lakeland Urology PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME0029790 Issued in FL

Legal business name

LAKELAND UROLOGY PA

Practice address

4435 Florida National Dr
Lakeland, FL 33813-1516

Phone

(863) 644-0471

Fax

(863) 644-9400

NPI assigned

Oct 19, 2007

Last updated

Dec 12, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eduardo C Moreno, M.D.

Title

Owner

Phone

(863) 644-0471

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alden Henry Reine Jr., MD

  • Urology Physician
  • Lincolnton, NC
  • NPI 1043264484
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1033308515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "HIGHLAND CITY",
            "state": "FL",
            "postal_code": "338460250",
            "telephone_number": "863-644-0471",
            "fax_number": "863-644-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 FLORIDA NATIONAL DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131516",
            "telephone_number": "863-644-0471",
            "fax_number": "863-644-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND UROLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-644-0471",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME0029790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeland SNF Operations LLC (Lakeland Center for Rehabilitation and Healing)
• Lakeland Sports Performance Inc (Velocity Chiropractic)
• Lakeland Surgical & Diagnostic Center LLP (Griffin Rd Campus of LSDC)
• Lakeland Therapy Providers, Inc
• Lakeland Therapy Providers, Inc.
• Lakeland Volunteers in Medicine
• Lakeland Volunteers in Medicine
• Lakeland Women's Health Center, Inc.
• Lakeland's Children Therapy Center, LLC
• Lakeside Medical Centers, Inc.

• Urology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.