Provider Demographics
NPI:1912468323
Name:GYNECOLOGY & OBSTETRICS ASSOCIATES OF TALLAHASSEE PLLC
Entity Type:Organization
Organization Name:GYNECOLOGY & OBSTETRICS ASSOCIATES OF TALLAHASSEE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURES-FORSTHOEFEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-877-3549
Mailing Address - Street 1:1405 CENTERVILLE RD STE 4200
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4622
Mailing Address - Country:US
Mailing Address - Phone:850-877-3549
Mailing Address - Fax:
Practice Address - Street 1:1405 CENTERVILLE RD STE 4200
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4622
Practice Address - Country:US
Practice Address - Phone:850-877-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty