Phoenix Obstetrics/Gynecology, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME39895 Issued in FL

Legal business name

PHOENIX OBSTETRICS/GYNECOLOGY, LLC

Practice address

200 NW 7TH Ave
Ft Lauderdale, FL 33311-9026

Phone

(954) 759-6789

Fax

(919) 425-0478

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

Gregory Byrne, MD

Title

President

Phone

(954) 838-2371

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565395200000",
    "number": "1225087315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "469-401-2386",
            "fax_number": "919-425-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NW 7TH AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333119026",
            "telephone_number": "954-759-6789",
            "fax_number": "919-425-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX OBSTETRICS/GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-08-10",
        "status": "A",
        "authorized_official_last_name": "BYRNE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-838-2371",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME39895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269096901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2019; 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.