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General NPI Number Information
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NPI Number | 1407865942
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Entity Type | Organization
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Legal Business Name | SUNCOAST OBSTETRICS & GYNECOLOGY, PA
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 11373 CORTEZ BLVD STE 207
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5405
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Country | US
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Telephone | 352-596-8911
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Fax |
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Provider Business Mailing Address
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Address Line | 11373 CORTEZ BLVD STE 207
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5405
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Country | US
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Telephone | 352-596-8911
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NILOUFER KERO
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Credential | M.D.
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Telephone | 352-596-8911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME43867
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License Number State | FL
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