Healthcare Provider Details

I. General information

NPI: 1225701915
Provider Name (Legal Business Name): OB HOSPITALIST GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 95TH ST
MIAMI FL
33150-2038
US

IV. Provider business mailing address

777 LOWNDES HILL RD BLDG 1
GREENVILLE SC
29607-2101
US

V. Phone/Fax

Practice location:
  • Phone: 864-908-3530
  • Fax:
Mailing address:
  • Phone: 864-908-3530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CLIFF LAWRENCE
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 800-967-2289