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Organization

PRIME OB/GYN P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MATTHEW R MERVIS M.D. (OWNER/PARTNER)
(407) 205-7646
Entity
Organization

Contact information

Practice address
1111 S ORANGE AVE, FOURTH FLOOR, ORLANDO, FL 32806-1236
(407) 205-7646
(407) 264-7774
Mailing address
773 TERRA PL, MAITLAND, FL 32751-4583
(407) 205-7646
(407) 264-7774

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
02/06/2013
Last updated
02/06/2013
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