Active NPI
Urology Professionals of South Florida LLC
- Urology Physician
- Hollywood, FL
National Provider Identifier
1467118745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- UROLOGY PROFESSIONALS OF SOUTH FLORIDA LLC
- Practice address
- 3939 Hollywood Blvd Ste 3a
Hollywood, FL 33021-6736 - Phone
- (954) 961-7700
- NPI assigned
- Nov 11, 2021
- Organization subpart
- Yes
- Parent organization
- UROLOGY PROFESSIONALS OF SOUTH FLORIDA LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Matthew Kobina Hasford, MD
- Title
- MGMR
- Phone
- (305) 836-1090
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
3939 Hollywood Blvd Ste 3a
Hollywood, FL 33021-6736
Mailing address
3700 Washington St Ste 104
Hollywood, FL 33021-8291
Phone (305) 836-1090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150518001796 | FL | Part B Supplier - Clinic/Group Practice | 9638499593 |
Receives reassigned benefits from 2 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hollywood, FL |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Urology Physician
- Hollywood, FL
- NPI 1578964524
O20150518001796
National Provider Directory
National Provider Directory- Tax ID family
- Urology Professionals of South Florida LLC
- Part of
- Urology Professionals of South Florida LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urology Physician
- Hollywood, FL
- NPI 1578964524
Locations
9400 NW 12th Ave
Ste 3
Miami, FL 33150
Phone (305) 836-1090
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Urology Physician
- Hollywood, FL
- NPI 1578964524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636588800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1636588800000",
"number": "1467118745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 WASHINGTON ST STE 104",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330218291",
"telephone_number": "305-836-1090",
"fax_number": "305-836-1199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3939 HOLLYWOOD BLVD STE 3A",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330216736",
"telephone_number": "954-961-7700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UROLOGY PROFESSIONALS OF SOUTH FLORIDA LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "UROLOGY PROFESSIONALS OF SOUTH FLORIDA LLC",
"enumeration_date": "2021-11-11",
"last_updated": "2021-11-11",
"certification_date": "2021-10-28",
"status": "A",
"authorized_official_last_name": "HASFORD",
"authorized_official_first_name": "MATTHEW",
"authorized_official_middle_name": "KOBINA",
"authorized_official_title_or_position": "MGMR",
"authorized_official_telephone_number": "305-836-1090",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.