# OB/GYN ULTRASOUND, LLC

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

## Provider details

- **NPI number:** 1164827010
- **Authorized official:** LUIS FERNANCO TOBON M.D., FACOG (MEDICAL DIRECTOR)
- **Authorized official phone:** (407) 492-5931

## Contact information

- **Practice address:** 5800 S SEMORAN BLVD, SUITE A, ORLANDO, FL 32822-4811
- **Practice address phone:** (407) 270-5925
- **Practice address fax:** (407) 205-1494
- **Mailing address:** 5800 S SEMORAN BLVD, SUITE A, ORLANDO, FL 32822-4811
- **Mailing address phone:** (407) 270-5925
- **Mailing address fax:** (407) 205-1494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME98764 | FL | Yes |
| 2471S1302X | Sonography Radiologic Technologist | 120313 | FL | — |

## Other

- **Enumeration date:** 11/04/2014
- **Last updated:** 02/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 008C7 | BCBS | FL |