Provider Demographics
NPI:1710213525
Name:ALL CHILDREN'S OB/GYN SPECIALISTS
Entity Type:Organization
Organization Name:ALL CHILDREN'S OB/GYN SPECIALISTS
Other - Org Name:WEST COAST NEONATALOGY, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:SCHULHOF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-898-7451
Mailing Address - Street 1:PO BOX 946298
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-6298
Mailing Address - Country:US
Mailing Address - Phone:727-344-6060
Mailing Address - Fax:727-369-4030
Practice Address - Street 1:5959 CENTRAL AVE STE 103
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8502
Practice Address - Country:US
Practice Address - Phone:727-344-6060
Practice Address - Fax:727-347-5586
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST COAST NEONATOLOGY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-29
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL60-414207V00000X
207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251391902Medicaid
FLCY392AMedicare PIN