# OB & GYN OF N E FL PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023311727
- **Authorized official:** DR. LAILA B NEEDHAM MD (OWNER)
- **Authorized official phone:** (386) 530-2380

## Contact information

- **Practice address:** 700 ZEAGLER DR, STE 3, PALATKA, FL 32177-6806
- **Practice address phone:** (386) 530-2380
- **Practice address fax:** (386) 530-2381
- **Mailing address:** PO BOX 658, PALATKA, FL 32178-0658
- **Mailing address phone:** (386) 530-2380
- **Mailing address fax:** (386) 530-2381

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/19/2010
- **Last updated:** 03/02/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000947900 | — | FL |
| 01 | — | EL011A | MEDICARE - PALATKA LOCATION | FL |
| 01 | — | EL011B | MEDICARE - ST. AUGUSTINE LOCATION | FL |