Organization
GULFSHORE UROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROLANDO RIVERA MD (SHAREHOLDER)
(239) 333-3200
Entity
Organization
Contact information
Practice address
28930 TRAILS EDGE BLVD, SUITE 200, BONITA SPRINGS, FL 34134-7582
(239) 333-3200
(239) 992-5785
Mailing address
28930 TRAILS EDGE BLVD, SUITE 200, BONITA SPRINGS, FL 34134-7582
(239) 333-3200
(239) 992-5785
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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