Provider Demographics
NPI:1447304134
Name:METRO-MIAMI OB/GYN ASSOCIATES, P.A.
Entity type:Organization
Organization Name:METRO-MIAMI OB/GYN ASSOCIATES, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ATA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATOGHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-653-4105
Mailing Address - Street 1:100 NW 170TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5511
Mailing Address - Country:US
Mailing Address - Phone:305-653-4105
Mailing Address - Fax:305-652-3566
Practice Address - Street 1:100 NW 170TH ST STE 304
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5511
Practice Address - Country:US
Practice Address - Phone:305-653-4105
Practice Address - Fax:305-652-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277714200Medicaid
FL020830900Medicaid
FLK5383OtherMEDICARE GROUP#