Provider Demographics
NPI:1164247235
Name:OBSTETRICS AND GYNECOLOGY ASSOCIATES OF CENTRAL FLORIDA, LLC
Entity type:Organization
Organization Name:OBSTETRICS AND GYNECOLOGY ASSOCIATES OF CENTRAL FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-300-2410
Mailing Address - Street 1:PO BOX 818018
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44181-8018
Mailing Address - Country:US
Mailing Address - Phone:561-300-2410
Mailing Address - Fax:
Practice Address - Street 1:6718 LAKE NONA BLVD STE 240
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7985
Practice Address - Country:US
Practice Address - Phone:407-846-7200
Practice Address - Fax:407-846-3989
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA WOMAN CARE ,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty