Organization Active NPI

Alliance Obstetrics and Gynecology Group, LLC

  • Obstetrics & Gynecology Physician
  • Winter Park, FL
National Provider Identifier
1841841830
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ALLIANCE OBSTETRICS AND GYNECOLOGY GROUP, LLC
Practice address
2035 Glenwood Dr
Winter Park, FL 32792-3307
Phone
(407) 960-2112
Fax
(407) 960-7024
NPI assigned
Sep 23, 2019
Last updated
Mar 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Ameigh Verderosa WorleyNPI 1336466911
Title
Owner/Physician
Phone
(321) 794-1864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary
Pediatric Adolescent Medicine Physician 2080A0000X

Addresses

Primary practice location

2035 Glenwood Dr
Winter Park, FL 32792-3307

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (407) 960-2112

Other practice location 1

2035 Glenwood Dr
Winter Park, FL 32792-3307
Phone (407) 960-2112

Other identifiers 2

IdentifierTypeStateIssuer
NP414OtherFLFL MEDICARE
PENDINGMedicaidFL

Other names 1

  • Alliance Obstetrics and Gynecology Group, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

2035 Glenwood Dr
Winter Park, FL 32792
Phone (407) 774-4440

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": "1569196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1841841830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "407-960-2112",
            "fax_number": "407-960-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 GLENWOOD DR",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923307",
            "telephone_number": "407-960-2112",
            "fax_number": "407-960-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2035 Glenwood Dr",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327923307",
            "country_code": "US",
            "telephone_number": "407-960-2112",
            "fax_number": "407-960-7024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLIANCE OBSTETRICS AND GYNECOLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-23",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "WORLEY",
        "authorized_official_first_name": "AMEIGH",
        "authorized_official_middle_name": "VERDEROSA",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "321-794-1864"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "NP414",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alliance Obstetrics and Gynecology Group, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Alliance Obstetrics and Gynecology Group, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.