Organization
FLORIDA PHYSICIAN SPECIALISTS LLC
Active
Other names
Urology Associates of Northeast Florida
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL D. TERK MD (AUTHORIZED OFFICIAL)
(904) 309-8680
Entity
Organization
Contact information
Practice address
1715 VILLAGE WAY, ORANGE PARK, FL 32073-5263
(904) 264-8418
(904) 264-9692
Mailing address
3599 UNIVERSITY BLVD S, SUITE 805, JACKSONVILLE, FL 32216-4252
(904) 309-8680
(904) 345-5841
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME59868
FL
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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