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General NPI Number Information
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NPI Number | 1215164363
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Entity Type | Organization
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Legal Business Name | OB GYN OF GREATER ORLANDO LLC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 5308 S JOHN YOUNG PKWY STE 300
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City | ORLANDO
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State | FL
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Zip | 32839-7362
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Country | US
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Telephone | 407-846-4882
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Fax | 407-355-3383
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Provider Business Mailing Address
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Address Line | 5308 S JOHN YOUNG PKWY STE 300
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City | ORLANDO
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State | FL
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Zip | 32839-7362
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Country | US
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Telephone | 407-846-4882
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Fax | 407-846-0416
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Authorized Official
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Title or Position | PARTNER/PHYSICIAN
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Name | GEROME ALEX CLEEFORD BELIARD
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Credential | MD
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Telephone | 407-846-4882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | FL
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