Organization
OB & GYN OF N E FL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAILA B NEEDHAM MD (OWNER)
(386) 530-2380
Entity
Organization
Contact information
Practice address
700 ZEAGLER DR, STE 3, PALATKA, FL 32177-6806
(386) 530-2380
(386) 530-2381
Mailing address
PO BOX 658, PALATKA, FL 32178-0658
(386) 530-2380
(386) 530-2381
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000947900
—
FL
01
—
EL011A
MEDICARE - PALATKA LOCATION
FL
01
—
EL011B
MEDICARE - ST. AUGUSTINE LOCATION
FL
Enumeration date
12/19/2010
Last updated
03/02/2013
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