NPIMap

Organization Active NPI

Innovative Gynecology LLC

  • Gynecology Physician
  • Sebastian, FL
National Provider Identifier
1740436831
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
OS10268 Issued in FL
Legal business name
INNOVATIVE GYNECOLOGY LLC
Practice address
709 Sebastian Blvd Ste F
Sebastian, FL 32958-8704
Phone
(772) 388-3332
Fax
(772) 388-3356
NPI assigned
Aug 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Authorized official

Name
Dr. Deborah Louise Kaufman, D.O.NPI 1285602375
Title
President
Phone
(772) 388-3332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X OS10268 FL Primary

Addresses

Primary practice location

709 Sebastian Blvd Ste F
Sebastian, FL 32958-8704

Mailing address

709 Sebastian Blvd Ste F
Sebastian, FL 32958-8704
Phone (772) 388-3332

Other identifiers 1

IdentifierTypeStateIssuer
48171OtherFLBLUE CROSS BLUE SHIELD OF FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1740436831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 SEBASTIAN BLVD STE F",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329588704",
            "telephone_number": "772-388-3332",
            "fax_number": "772-388-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 SEBASTIAN BLVD STE F",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329588704",
            "telephone_number": "772-388-3332",
            "fax_number": "772-388-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE GYNECOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-388-3332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "OS10268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FL",
            "identifier": "48171",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.