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Organization
CENTRAL FL REG OBSTETRICS AND GYNECOLOGY, LLC
Active
Organization
CENTRAL FL REG OBSTETRICS AND GYNECOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY PICKLER (VP)
(850) 523-2117
Entity
Organization
Contact information
Practice address
1000 EXECUTIVE DR, SUITE 3, OVIEDO, FL 32765-8140
(407) 365-2929
Mailing address
1000 EXECUTIVE DR, SUITE 3, OVIEDO, FL 32765-8140
(407) 365-2929
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74908
BCBS OF FL
FL
Enumeration date
06/07/2006
Last updated
08/29/2007
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