UROLOGY MEDICAL SPECIALISTS, PA
Medical Practice at Sample Rd, Pompano Beach, FL

License number
Florida ME105426
Category
Medical Practice
Type
Specialist
Owner
Name: DR. SANJEEV K GUPTA M.D.
Title: PRESIDENT
Phone: (954) 943-1133
Address
Address
601 EAST Sample Rd SUITE 105, Pompano Beach, FL 33064
National Provider ID: 1164772935
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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UROLOGY MEDICAL SPECIALISTS, PA

601 E Sample Rd SUITE 105, Pompano Beach, FL 33064

Status:
Inactive
Inactive reason:
Name Change Amendment
Registration:
Jul 27, 2012
Inactive since:
Aug 29, 2012
State ID:
P12000065554
Business type:
Florida Profit Corporation
President:
Sanjeev Gupta (President), 601 E Sample Rd SUITE 105, Pompano Beach, FL 33064 (Physical)
Agent:
Gupta, Sanjeev,601 E Sample Rd SUITE 105, Pompano Beach, FL 33064 (Physical)
EIN:
46-0663349

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