Organization
ADVANCED WOMEN'S UROLOGY AND GYNECOLOGY, PLLC
Active
Organization
ADVANCED WOMEN'S UROLOGY AND GYNECOLOGY, PLLC
Active
Parent organization
ADVANCED WOMEN'S UROLOGY AND GYNECOLOGY, PLLC
Other names
Advanced Urogynecology
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED WOMEN'S UROLOGY AND GYNECOLOGY, PLLC
Authorized official
DR. KRISTIN M. JACKSON MD (OWNER)
(407) 898-9804
Entity
Organization
Contact information
Practice address
2501 N ORANGE AVE, SUITE 210, ORLANDO, FL 32804-4603
(407) 898-9804
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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