INDIAN RIVER UROLOGY ASSOCIATES PA
Urology at 37 St, Vero Beach, FL

License number
Florida ME0048626
Category
Radiology
Type
Urology
Owner
Name: MARC CARLTON ROSE M.D.
Title: PRESIDENT
Phone: (772) 567-3003
Address
Address
787 37Th St SUITE E200, Vero Beach, FL 32960
National Provider ID: 1164610895
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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INDIAN RIVER UROLOGY ASSOCIATES, PA

787 37 St SUITE E 200, Vero Beach, FL 32960

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
Reinstatement
Registration:
Dec 20, 1968
Inactive since:
Jun 5, 2012
Phone:
(772) 567-3003 (Phone)
State ID:
600684
Business type:
Florida Profit Corporation
Directors:
Marc C Rose Md, 787 37 St E-200, Vero Beach, FL 32960 (Physical),Marc C. Rose (Director)
Agent:
Rose, Marc M, Md,787 37 St SUITE E 200, Vero Beach, FL 32960 (Physical)
EIN:
591225755

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