Organization
OB/GYN ULTRASOUND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS FERNANCO TOBON M.D., FACOG (MEDICAL DIRECTOR)
(407) 492-5931
Entity
Organization
Contact information
Practice address
5800 S SEMORAN BLVD, SUITE A, ORLANDO, FL 32822-4811
(407) 270-5925
(407) 205-1494
Mailing address
5800 S SEMORAN BLVD, SUITE A, ORLANDO, FL 32822-4811
(407) 270-5925
(407) 205-1494
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME98764
FL
2471S1302X
Sonography Radiologic Technologist
120313
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008C7
BCBS
FL
Enumeration date
11/04/2014
Last updated
02/05/2016
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