Organization
CHILDRENS UROLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDA M MOY (OFFICE MANAGER)
(305) 669-6448
Entity
Organization
Contact information
Practice address
3200 SW 60TH CT, SUITE 104, MIAMI, FL 33155-4000
(305) 669-6448
(305) 663-8485
Mailing address
3200 SW 60TH CT, SUITE 104, MIAMI, FL 33155-4000
(305) 669-6448
(305) 663-8485
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255861100
—
FL
01
—
38599
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/09/2006
Last updated
05/22/2008
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