# NEW SMYRNA BEACH GYNECOLOGY & OBSTETRICS PA

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

## Provider details

- **NPI number:** 1245233725
- **Authorized official:** JACOB DUDLEY ROUSE JR. MD (PRESIDENT)
- **Authorized official phone:** (386) 423-0333

## Contact information

- **Practice address:** 603 S ORANGE ST, NEW SMYRNA BEACH, FL 32168-7320
- **Practice address phone:** (386) 423-0333
- **Practice address fax:** (386) 423-0042
- **Mailing address:** 603 S ORANGE ST, NEW SMYRNA BEACH, FL 32168-7320
- **Mailing address phone:** (386) 423-0333
- **Mailing address fax:** (386) 423-0042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME32999 | FL | Yes |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | RN2893652 | FL | — |

## Other

- **Enumeration date:** 05/27/2005
- **Last updated:** 09/07/2012