Healthcare Provider Details
I. General information
NPI: 1003106915
Provider Name (Legal Business Name): FLORIDA WOMAN CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/12/2011
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3251 N MCMULLEN BOOTH RD STE 102
CLEARWATER FL
33761-2022
US
IV. Provider business mailing address
4205 W ATLANTIC AVE SUITE C-304
DELRAY BEACH FL
33445-3901
US
V. Phone/Fax
- Phone: 727-669-6811
- Fax:
- Phone: 561-300-2410
- Fax: 561-495-5408
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
MATTHEW
SUDBURY
Title or Position: PRESIDENT
Credential:
Phone: 941-745-5115