Organization
ADVANCED UROLOGY INSTITUTE LLC
Active
Parent organization
ADVANCED UROLOGY INSTITUTE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED UROLOGY INSTITUTE LLC
Authorized official
RICHARD WOOTEN (CEO)
(919) 397-8768
Entity
Organization
Contact information
Practice address
210 S LAKE ST STE 9, LEESBURG, FL 34748-7369
(352) 787-4567
Mailing address
210 S LAKE ST STE 9, LEESBURG, FL 34748-7369
(352) 787-4567
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/05/2022
Last updated
04/02/2024
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