=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013195783
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH FLORIDA OBSTETRICAL AND GYNECOLOGICAL SERVICES PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2008
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4101 NW 3RD CT STE 11
-----------------------------------------------------
City | PLANTATION
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33317-2830
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-452-4377
-----------------------------------------------------
Fax | 954-452-1022
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4101 NW 3RD CT STE 11
-----------------------------------------------------
City | PLANTATION
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33317-2830
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-452-4377
-----------------------------------------------------
Fax | 954-452-1022
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. CECILLE B ALEXIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-452-4377
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | ME78854
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | ME36984
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------