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Organization
FIRST COAST OBSTETRICS AND GYNECOLOGY PA
Active
Organization
FIRST COAST OBSTETRICS AND GYNECOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCIEN - MAXIMIN YANOU TCHUISSE M.D. (PRESIDENT)
(386) 325-5699
Entity
Organization
Contact information
Practice address
6100 SAINT JOHNS AVE, SUITE 6, PALATKA, FL 32177
(386) 325-5699
Mailing address
6100 SAINT JOHNS AVE STE 6, PALATKA, FL 32177-6859
(386) 325-5699
(386) 325-5644
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
FL
261QR1300X
Rural Health Clinic/Center
—
NULL
Other
Enumeration date
03/24/2011
Last updated
09/21/2018
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