Organization Active NPI

Urology Professionals of South Florida LLC

  • Urology Physician
  • Hollywood, FL
National Provider Identifier
1467118745
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
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 LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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.

National Provider Directory

National Provider Directory
Tax ID family
Urology Professionals of South Florida LLC2 organizations share this tax ID, including this one
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.

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.

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.

Verify at the official NPI Registry.