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General NPI Number Information
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NPI Number | 1356655534
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA OBSTETRICS & GYNECOLOGY, LLC
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 7150 W 20TH AVE STE 604
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City | HIALEAH
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State | FL
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Zip | 33016-5534
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Country | US
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Telephone | 305-556-8353
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Fax | 305-827-2415
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Provider Business Mailing Address
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Address Line | 7150 W 20TH AVE STE 604
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City | HIALEAH
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State | FL
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Zip | 33016-5534
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Country | US
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Telephone | 305-556-8353
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Fax | 305-827-2415
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. CHRISTY MICHELLE GONZALEZ
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Credential |
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Telephone | 305-556-8353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME 35393
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License Number State | FL
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Taxonomy #2
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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 |
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