Healthcare Provider Details

I. General information

NPI: 1164478582
Provider Name (Legal Business Name): INSTITUTE FOR WOMENS HEALTH SPECIALISTS OF SOUTH FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 W HILLSBORO BLVD SUITE 207
COCONUT CREEK FL
33073-4395
US

IV. Provider business mailing address

1395 S STATE ROAD 7 SUITE 450
WELLINGTON FL
33414-9325
US

V. Phone/Fax

Practice location:
  • Phone: 954-570-7644
  • Fax: 954-570-7884
Mailing address:
  • Phone: 561-798-1233
  • Fax: 561-578-4181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SETH J HERBST
Title or Position: PRESIDENT
Credential: MD
Phone: 561-798-1233