Organization
UROLOGY SPECIALTY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN J BONDHUS MD (PRESIDENT)
(305) 661-9692
Entity
Organization
Contact information
Practice address
7000 SW 62ND AVE, STE. 340, SOUTH MIAMI, FL 33143-4716
(305) 661-9692
(305) 667-0630
Mailing address
7000 SW 62ND AVE, STE. 340, SOUTH MIAMI, FL 33143-4716
(305) 661-9692
(305) 667-0630
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271579100
—
FL
05
—
271579101
—
FL
05
—
271579102
—
FL
05
—
271579103
—
FL
05
—
271579104
—
FL
05
—
271579105
—
FL
05
—
271579107
—
FL
05
—
271579108
—
FL
05
—
271579109
—
FL
05
—
271579110
—
FL
05
—
271579111
—
FL
05
—
271579112
—
FL
05
—
271579113
—
FL
05
—
271579114
—
FL
05
—
271579116
—
FL
05
—
271579117
—
FL
05
—
271579118
—
FL
01
—
5636224
CIGNA
FL
01
—
74984
BLUE CROSS BLUE SHIELD
FL
01
—
DD3820
RAILROAD MEDICARE
FL
01
—
DE4135
RAILROAD MEDICARE
FL
Enumeration date
07/07/2006
Last updated
05/09/2008
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