# ADVANCED UROLOGY INSTITUTE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ADVANCED UROLOGY INSTITUTE LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770293300
- **Legal business name:** ADVANCED UROLOGY INSTITUTE LLC
- **Authorized official:** RICHARD WOOTEN (CEO)
- **Authorized official phone:** (919) 397-8768

## Contact information

- **Practice address:** 6811 PALISADES PARK CT STE 1, FORT MYERS, FL 33912-7130
- **Practice address phone:** (239) 533-5177
- **Mailing address:** 6811 PALISADES PARK CT STE 1, FORT MYERS, FL 33912-7130
- **Mailing address phone:** (239) 533-5177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 12/05/2022
- **Last updated:** 04/02/2024