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NPI Code Detail

MEDICARE: FLORIDA WOMAN CARE, LLC

MEDICARE: FLORIDA WOMAN CARE, LLC
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
1207VG0400XGynecology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982279667
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA WOMAN CARE, LLC
Provider Business Mailing Address
First Line : PO BOX 9100
Second Line :
City : BELFAST
State : ME
Zip : 04915-9100
Country : US
Telephone Number : 561-300-2410
Fax Number : 561-235-7292
Provider Business Practice Location Address
First Line : 101 SE 27TH AVE
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33435-7632
Country : US
Telephone Number : 561-738-9761
Fax Number : 561-738-5592
Authorized Official
Title or Position : MANAGER
Name : ERICA HERNANDEZ
Credential :
Telephone Number : 561-300-2410
Provider Enumeration Date : 05/25/2021
Last Update Date : 06/21/2022

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Directions to “FLORIDA WOMAN CARE, LLC ” Practice Location

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