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Organization
ELITE OB-GYN SURGERY LLC
Active
Organization
ELITE OB-GYN SURGERY LLC
Active
Other names
Elite OB/GYN Surgery LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNNY RIVERA JR. (ADMINISTRATOR)
(407) 529-7752
Entity
Organization
Contact information
Practice address
801 N ORANGE AVE STE 710, ORLANDO, FL 32801-5202
(407) 529-7752
(407) 459-7542
Mailing address
801 N ORANGE AVE STE 710, ORLANDO, FL 32801-5202
(407) 529-7752
(407) 459-7542
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VG0400X
Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
363L00000X
Nurse Practitioner
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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