| NPI | 1437806197 |
|---|---|
| Doing Business As | MODERN UROLOGY |
| Entity Type | Organization |
| Authorized Contact | ADAM MICHAEL DE FAZIO Physician 954-770-1666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2022-07-24 |