| Doctor Name: | DR. PETER URBAN |
| NPI Number: | 1104045103 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME0042819 |
| Business Practice Address: | 555 N Byron Butler Pkwy Perry, FL - 323472315 |
| Business Phone Number: | 8505842778 |
| Business Fax Number: | 8505842790 |
| Mailing Address: | 555 N Byron Butler Pkwy, PERRY |
| State: | FL |
| Postal Code: | 323472315 |
| Phone Number: | 8505842778 |
| Fax Number: | 8505842790 |
| NPI Enumeration Date: | 04/25/2007 |
| NPI Last Update Date: | 10/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | ME0042819 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |