PLANTATION PAVILION OB-GYN NPI 1093126591

NPI Information

NPI: 1093126591
Provider Name: PLANTATION PAVILION OB-GYN
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

Address:
4330 W BROWARD BLVD
STE C
PLANTATION, FL
ZIP 33317
Phone: (954) 587-0351
Get Directions

PLANTATION PAVILION OB-GYN is a gynecology obstetrics gynecology in Plantation, FL. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee PLANTATION PAVILION OB-GYN NPI is 1093126591. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4330 W BROWARD BLVD
STE C
PLANTATION, FL
ZIP 33317-775
Phone: (954) 587-0351
Fax: (954) 990-6464

The provider's authorized official is Georges Edouard .
The authorized official title is Ob-gyn and has the following contact phone number (954) 587-0351.

The enumeration date for this NPI number is 5/19/2014 and was last updated on 5/19/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VG0400X	Obstetrics & Gynecology	Gynecology		FLORIDA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	650305871	MEDICAID	FLORIDA

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: 5/5/2024

NPI Synchronization or Removal

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