# SUNCOAST OBSTETRICS AND GYNECOLOGY PA

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

## Provider details

- **NPI number:** 1295923688
- **Authorized official:** MRS. STACEY ANN LAWLOR (ASSISTANT MANAGER)
- **Authorized official phone:** (352) 564-8245

## Contact information

- **Practice address:** 582 SE 7TH AVE, CRYSTAL RIVER, FL 34429-4840
- **Practice address phone:** (352) 564-8245
- **Mailing address:** PO BOX 1117, CRYSTAL RIVER, FL 34423-1117
- **Mailing address phone:** (352) 564-8245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME62824 | FL | Yes |

## Other

- **Enumeration date:** 10/10/2007
- **Last updated:** 01/06/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 269427100 | — | FL |