Provider Demographics
NPI:1144221532
Name:GOSS, PARKER AND QUINSEY, P.A.
Entity Type:Organization
Organization Name:GOSS, PARKER AND QUINSEY, P.A.
Other - Org Name:ADVANCED WOMEN'S HEALTH SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:V
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-834-8111
Mailing Address - Street 1:785 PRIMERA BLVD
Mailing Address - Street 2:SUITE 1031
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2124
Mailing Address - Country:US
Mailing Address - Phone:407-834-8111
Mailing Address - Fax:407-708-1958
Practice Address - Street 1:785 PRIMERA BLVD
Practice Address - Street 2:SUITE 1031
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2124
Practice Address - Country:US
Practice Address - Phone:407-834-8111
Practice Address - Fax:407-708-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL592440426207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372267800Medicaid