Healthcare Provider Details

I. General information

NPI: 1508549569
Provider Name (Legal Business Name): FLORIDA WOMAN CARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 COMMERCE PARK DR STE 3001
ALTAMONTE SPRINGS FL
32714-2091
US

IV. Provider business mailing address

PO BOX 9100
BELFAST ME
04915-9100
US

V. Phone/Fax

Practice location:
  • Phone: 407-857-2502
  • Fax:
Mailing address:
  • Phone: 561-300-2410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ERICA HERNANDEZ
Title or Position: MANAGER
Credential:
Phone: 561-300-2410