# ADVANCED INSTITUTE OF OBSTETRICS AND GYNECOLOGY OF SOUTH FLORIDA

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

## Provider details

- **NPI number:** 1568589315
- **Authorized official:** ELIAS JOSE MUALIN (PRESIDENT)
- **Authorized official phone:** (954) 983-2101

## Contact information

- **Practice address:** 1111 N 35TH AVE, HOLLYWOOD, FL 33021-5403
- **Practice address phone:** (954) 983-2101
- **Mailing address:** 1111 N 35TH AVE, HOLLYWOOD, FL 33021-5403
- **Mailing address phone:** (954) 983-2101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME86605 | FL | Yes |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 05/19/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 266415101 | — | FL |
| 01 | — | 29130 | BLUE CROSS BLUE SHIELD | FL |