Organization
INNOVATIVE GYNECOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH LOUISE KAUFMAN D.O. (PRESIDENT)
(772) 388-3332
Entity
Organization
Contact information
Practice address
709 SEBASTIAN BLVD STE F, SEBASTIAN, FL 32958-8704
(772) 388-3332
(772) 388-3356
Mailing address
709 SEBASTIAN BLVD STE F, SEBASTIAN, FL 32958-8704
(772) 388-3332
(772) 388-3356
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
OS10268
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48171
BLUE CROSS BLUE SHIELD OF FL
FL
Enumeration date
08/08/2008
Last updated
08/11/2011
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