NPIMap

Organization Active NPI

Indian River Urology Associates PA

  • Urology Physician
  • Vero Beach, FL
National Provider Identifier
1164610895
Registry record updated Mar 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME0048626 Issued in FL
Legal business name
INDIAN RIVER UROLOGY ASSOCIATES PA
Practice address
787 37TH St
Suite E200
Vero Beach, FL 32960-7305
Phone
(772) 567-3003
Fax
(772) 567-2926
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2008

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

Authorized official

Name
Marc Carlton Rose, M.D.
Title
President
Phone
(772) 567-3003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X ME0048626 FL Primary

Addresses

Primary practice location

787 37TH St
Suite E200
Vero Beach, FL 32960-7305

Mailing address

787 37TH St
Suite E200
Vero Beach, FL 32960-7305
Phone (772) 567-3003

National Provider Directory

National Provider Directory

Locations

787 37th St
Ste E200
Vero Beach, FL 32960
Phone (772) 567-3003

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204329600000",
    "number": "1164610895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 37TH ST",
            "address_2": "SUITE E200",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607305",
            "telephone_number": "772-567-3003",
            "fax_number": "772-567-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 37TH ST",
            "address_2": "SUITE E200",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607305",
            "telephone_number": "772-567-3003",
            "fax_number": "772-567-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER UROLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2008-03-01",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "CARLTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-567-3003",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "FL",
            "license": "ME0048626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2008; 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.