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Organization

NEW SMYRNA BEACH GYNECOLOGY & OBSTETRICS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB DUDLEY ROUSE JR. MD (PRESIDENT)
(386) 423-0333
Entity
Organization

Contact information

Practice address
603 S ORANGE ST, NEW SMYRNA BEACH, FL 32168-7320
(386) 423-0333
(386) 423-0042
Mailing address
603 S ORANGE ST, NEW SMYRNA BEACH, FL 32168-7320
(386) 423-0333
(386) 423-0042

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME32999
FL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
RN2893652
FL

Other

Enumeration date
05/27/2005
Last updated
09/07/2012
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