Healthcare Provider Details

I. General information

NPI: 1871806026
Provider Name (Legal Business Name): WOMEN'S HEALTH CARE AT CENTER FOR BALANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 NW 6TH ST
GAINESVILLE FL
32609-3531
US

IV. Provider business mailing address

1705 NW 6TH ST
GAINESVILLE FL
32609-3531
US

V. Phone/Fax

Practice location:
  • Phone: 352-505-5581
  • Fax: 352-378-5166
Mailing address:
  • Phone: 352-505-5581
  • Fax: 352-378-5166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number731722
License Number StateFL

VIII. Authorized Official

Name: LOUANN HILLEBRAND
Title or Position: CERTIFIED NURSE MIDWIFE
Credential:
Phone: 352-505-5581