| Urolife Clinic Llc | |
|
256 Sw Professional Gln Lake City FL 32025-1104 | |
| (386) 758-8937 | |
| Not Available |
| Full Name | Urolife Clinic Llc |
|---|---|
| Speciality | Urology |
| Location | 256 Sw Professional Gln, Lake City, Florida |
| Authorized Official Name and Position | Sarah C Dumas (MANAGER) |
| Authorized Official Contact | 3867588937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Urolife Clinic Llc 256 Sw Professional Gln Lake City FL 32025-1104 Ph: (386) 758-8937 | Urolife Clinic Llc 256 Sw Professional Gln Lake City FL 32025-1104 Ph: (386) 758-8937 |
| NPI Number | 1477377026 |
|---|---|
| Provider Enumeration Date | 11/11/2024 |
| Last Update Date | 04/10/2025 |
| Medicare PECOS PAC ID | 5294263810 |
|---|---|
| Medicare Enrollment ID | O20250110000734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477377026 | NPI | - | NPPES |
| Provider Name | Jennifer Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316581879 PECOS PAC ID: 8527498914 Enrollment ID: I20200427001990 |
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