Organization
THE CENTER FOR ADVANCED GYNECOLOGY AND AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA CASELLA (ADMINISTRATOR)
(407) 908-6209
Entity
Organization
Contact information
Practice address
205 PARK PLACE BLVD, KISSIMMEE, FL 34741-2345
(727) 456-4250
(727) 346-1044
Mailing address
1033 DR MARTIN LUTHER KING JR ST N, STE. 108, ST PETERSBURG, FL 33701-1547
(727) 456-4250
(727) 346-1044
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME52981
FL
Other
Enumeration date
02/08/2010
Last updated
02/08/2010
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