Organization Active NPI

Central FL Reg Obstetrics and Gynecology, LLC

  • Obstetrics & Gynecology Physician
  • Oviedo, FL
National Provider Identifier
1790725117
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CENTRAL FL REG OBSTETRICS AND GYNECOLOGY, LLC
Practice address
1000 Executive Dr
Suite 3
Oviedo, FL 32765-8140
Phone
(407) 365-2929
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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

Authorized official

Name
Mickey Pickler
Title
VP
Phone
(850) 523-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1000 Executive Dr
Suite 3
Oviedo, FL 32765-8140

Mailing address

1000 Executive Dr
Suite 3
Oviedo, FL 32765-8140
Phone (407) 365-2929

Other identifiers 1

IdentifierTypeStateIssuer
74908OtherFLBCBS OF FL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1790725117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EXECUTIVE DR",
            "address_2": "SUITE 3",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658140",
            "telephone_number": "407-365-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EXECUTIVE DR",
            "address_2": "SUITE 3",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658140",
            "telephone_number": "407-365-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FL REG OBSTETRICS AND GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "850-523-2117"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "74908",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.