Provider Demographics
NPI:1215379011
Name:MINIMALLY INVASIVE GYNECOLOGY PLLC
Entity Type:Organization
Organization Name:MINIMALLY INVASIVE GYNECOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GYANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-556-3973
Mailing Address - Street 1:3004 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-6011
Mailing Address - Country:US
Mailing Address - Phone:407-556-3973
Mailing Address - Fax:321-805-4718
Practice Address - Street 1:3004 17TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6011
Practice Address - Country:US
Practice Address - Phone:407-556-3973
Practice Address - Fax:321-805-4718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110498207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty