Provider Demographics
NPI:1174931190
Name:URBANEK, BRIAN WILLIAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WILLIAM
Last Name:URBANEK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 NE 42ND ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4660
Mailing Address - Country:US
Mailing Address - Phone:954-881-3347
Mailing Address - Fax:
Practice Address - Street 1:11650 MIRAMAR PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5821
Practice Address - Country:US
Practice Address - Phone:954-378-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist