Provider Demographics
NPI:1740200260
Name:ASSOCIATES OF OBSTERICS & GYNECOLOGY, PA
Entity Type:Organization
Organization Name:ASSOCIATES OF OBSTERICS & GYNECOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:DELCHARCO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-690-6300
Mailing Address - Street 1:2801 SE 1ST AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0409
Mailing Address - Country:US
Mailing Address - Phone:352-690-6300
Mailing Address - Fax:352-690-6802
Practice Address - Street 1:2801 SE 1ST AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0409
Practice Address - Country:US
Practice Address - Phone:352-690-6300
Practice Address - Fax:352-690-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064539207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255926900Medicaid
FLG27976Medicare UPIN
FL255926900Medicaid