Organization
BROWARD UROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A SIMON MD (PRESIDENT)
(954) 499-7696
Entity
Organization
Contact information
Practice address
700 N HIATUS RD, SUITE 101, PEMBROKE PINES, FL 33026-5206
(954) 499-7696
(954) 499-7699
Mailing address
700 N HIATUS RD, SUITE 101, PEMBROKE PINES, FL 33026-5206
(954) 499-7696
(954) 499-7699
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME89935
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98445
BCBS
FL
Enumeration date
07/19/2005
Last updated
05/23/2008
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