MEDICARE: APS GYNECOLOGY, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME0070754	FL
2	207V00000X	Obstetrics & Gynecology Physician	ME0043806	FL

General Provider Information

NPI Number	:	1568456820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APS GYNECOLOGY, PA

Provider Business Mailing Address
First Line	:	4302 N HABANA AVE STE 300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6368
Country	:	US
Telephone Number	:	813-870-3890
Fax Number	:	813-877-8517

Provider Business Practice Location Address
First Line	:	2901 W SAINT ISABEL ST
Second Line	:	STE B
City	:	TAMPA
State	:	FL
Zip	:	33607-6371
Country	:	US
Telephone Number	:	813-870-3890
Fax Number	:	813-877-8517

Authorized Official
Title or Position	:	COO
Name	:	RICHARD LOUIS PAULA
Credential	:	MD
Telephone Number	:	813-787-7350

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	09/06/2023

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