Advanced Women's Urology and Gynecology, PLLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

ADVANCED WOMEN'S UROLOGY AND GYNECOLOGY, PLLC

Doing business as

Advanced Urogynecology

Practice address

2501 N Orange Ave
Suite 210
Orlando, FL 32804-4603

Phone

(407) 898-9804

NPI assigned

May 15, 2012

Last updated

May 15, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

ADVANCED WOMEN'S UROLOGY AND GYNECOLOGY, PLLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kristin M. Jackson, MD

Title

Owner

Phone

(407) 898-9804

Specialties & licenses 1

Addresses

Other names 1

• Advanced Urogynecology Doing business as

Part of

Advanced Women's Urology and Gynecology PLLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1033478755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "address_2": "SUITE 210",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-898-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WOMEN'S UROLOGY AND GYNECOLOGY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED WOMEN'S UROLOGY  AND GYNECOLOGY, PLLC",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-898-9804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Urogynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-Pharmacy Dispensing Site in Orlando, FL
• Providers in Orlando, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.