Organization
CENTRAL FL REG OBSTETRICS AND GYNECOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY PICKLER (VP)
(850) 523-2117
Entity
Organization
Contact information
Practice address
1000 EXECUTIVE DR, SUITE 3, OVIEDO, FL 32765-8140
(407) 365-2929
Mailing address
1000 EXECUTIVE DR, SUITE 3, OVIEDO, FL 32765-8140
(407) 365-2929
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74908
BCBS OF FL
FL
Enumeration date
06/07/2006
Last updated
08/29/2007
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