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PHOENIX OBSTETRICS AND GYNECOLOGY LLC NPI 1902944382


NPI Information

NPI: 1902944382
Provider Name: PHOENIX OBSTETRICS AND GYNECOLOGY LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1600 S ANDREWS AVE
FT LAUDERDALE, FL
ZIP 33316
Phone: (954) 355-5017
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PHOENIX OBSTETRICS AND GYNECOLOGY LLC is a specialist in Ft Lauderdale, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PHOENIX OBSTETRICS AND GYNECOLOGY LLC NPI is 1902944382. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1600 S ANDREWS AVE
FT LAUDERDALE, FL
ZIP 33316-510
Phone: (954) 355-5017
Fax: (954) 714-6335

The provider's authorized official is Bertrum Walls .
The authorized official title is President and has the following contact phone number (954) 355-5017.

The enumeration date for this NPI number is 2/1/2007 and was last updated on 5/22/2009.


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
1174400000XSpecialistME43546FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1269096902MEDICAIDFLORIDA
2K7041MEDICARE PINFLORIDA

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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