MEDICARE: SOUTH FLORIDA WOMEN'S WELLNESS AND AESTHETICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician

General Provider Information

NPI Number	:	1932938636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA WOMEN'S WELLNESS AND AESTHETICS

Provider Business Mailing Address
First Line	:	534 NE 8TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-1214
Country	:	US
Telephone Number	:	954-629-0054
Fax Number	:

Provider Business Practice Location Address
First Line	:	3042 N FEDERAL HWY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1400
Country	:	US
Telephone Number	:	954-776-4877
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. SWETA MEHTA
Credential	:	DO
Telephone Number	:	954-907-4689

Provider Enumeration Date	:	07/31/2024
Last Update Date	:	07/31/2024

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