Organization Active NPI

Marianna OB GYN Associates P a

  • Specialist
  • Marianna, FL
National Provider Identifier
1962532655
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0068116 Issued in FL
Legal business name
MARIANNA OB GYN ASSOCIATES P A
Practice address
4230 Hospital Dr
Suite 209
Marianna, FL 32446-1955
Phone
(850) 482-6484
Fax
(850) 482-5713
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Authorized official

Name
Dr. Orlando S Muniz
Title
Owner
Phone
(850) 482-6484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME0068116 FL Primary

Addresses

Primary practice location

4230 Hospital Dr
Suite 209
Marianna, FL 32446-1955

Mailing address

4230 Hospital Drive
Suite 209
Marianna, FL 32446-1955
Phone (850) 482-6484

Other identifiers 2

IdentifierTypeStateIssuer
21956OtherFLBCBS GROUP
254870400MedicaidFL

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1962532655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 HOSPITAL DRIVE",
            "address_2": "SUITE 209",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461955",
            "telephone_number": "850-482-6484",
            "fax_number": "850-482-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HOSPITAL DR",
            "address_2": "SUITE 209",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461955",
            "telephone_number": "850-482-6484",
            "fax_number": "850-482-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIANNA OB GYN ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "MUNIZ",
        "authorized_official_first_name": "ORLANDO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-482-6484",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0068116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "21956",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254870400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.