Healthcare Provider Details

I. General information

NPI: 1396149258
Provider Name (Legal Business Name): OBSTETRICS AND GYNECOLOGY SPECIALISTS OF CENTRAL FLORIDA, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2014
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S SEMORAN BLVD
ORLANDO FL
32807-3005
US

IV. Provider business mailing address

930 S SEMORAN BLVD
ORLANDO FL
32807-3005
US

V. Phone/Fax

Practice location:
  • Phone: 407-207-6768
  • Fax: 407-249-5025
Mailing address:
  • Phone: 407-207-6768
  • Fax: 407-249-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME92942
License Number StateFL

VIII. Authorized Official

Name: DR. JUAN C NARVAEZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 407-207-6768