Healthcare Provider Details

I. General information

NPI: 1073181236
Provider Name (Legal Business Name): FLORIDA WOMAN CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W 84TH ST STE 500
HIALEAH FL
33016-5780
US

IV. Provider business mailing address

PO BOX 9100
BELFAST ME
04915-9100
US

V. Phone/Fax

Practice location:
  • Phone: 305-512-4858
  • Fax: 305-824-9206
Mailing address:
  • Phone: 561-300-2410
  • Fax: 561-235-7292

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