Phoenix Obsterics/gynecology, LLC

NPI #1568411700 in Ft Lauderdale, Florida

Provider Information

NPI Number: 1568411700
Entity Type: Organization
Organization Name: Phoenix Obsterics/gynecology, LLC
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: May 6, 2006
Last Updated: Aug 10, 2019

Practice Location

Address: 500 SE 17TH ST
Address 2: SUITE 100
City: Ft Lauderdale
State: Florida
ZIP Code: 33316-2547
Phone: (919) 425-1565

Authorized Official

Name: DR. BERTRAM WALLS, MD
Title: PRESIDENT
Phone: (954) 838-2371

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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