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General NPI Number Information
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NPI Number | 1841841830
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Entity Type | Organization
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Legal Business Name | ALLIANCE OBSTETRICS AND GYNECOLOGY GROUP, LLC
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 2035 GLENWOOD DR
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City | WINTER PARK
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State | FL
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Zip | 32792-3307
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Country | US
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Telephone | 407-960-2112
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Fax | 407-960-7024
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Provider Business Mailing Address
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Address Line | 3300 S FISKE BLVD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-4306
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Country | US
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Telephone | 407-960-2112
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Fax | 407-960-7024
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | AMEIGH VERDEROSA WORLEY
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Credential |
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Telephone | 321-794-1864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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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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