Provider Demographics
NPI:1235460775
Name:NEW BEGINNINGS OBGYN PA
Entity Type:Organization
Organization Name:NEW BEGINNINGS OBGYN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-775-1470
Mailing Address - Street 1:PO BOX 410755
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32941-0755
Mailing Address - Country:US
Mailing Address - Phone:321-775-1470
Mailing Address - Fax:
Practice Address - Street 1:336 N BABCOCK ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-7325
Practice Address - Country:US
Practice Address - Phone:321-775-1470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90087207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269744100Medicaid
FL269744100Medicaid
FLI07443Medicare UPIN