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MAGNOLIA GYNECOLOGY LLC NPI 1063024149


NPI Information

NPI: 1063024149
Provider Name: MAGNOLIA GYNECOLOGY, LLC
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 10D2209727

Address:
105 S MACDILL AVE STE 202
TAMPA, FL
ZIP 33609
Phone: (813) 773-6627
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MAGNOLIA GYNECOLOGY, LLC is an obstetrics gynecology in Tampa, FL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. MAGNOLIA GYNECOLOGY, LLC NPI is 1063024149. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

105 S MACDILL AVE STE 202
TAMPA, FL
ZIP 33609-490
Phone: (813) 773-6627
Fax: (813) 443-6001

The provider's authorized official is Alexandria R Reyes .
The authorized official title is Owner and has the following contact phone number (813) 773-6627.

The CLIA number assigned to this NPI record is 10D2209727 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/19/2020 and was last updated on 2/21/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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