Healthcare Provider Details
I. General information
NPI: 1699342311
Provider Name (Legal Business Name): FLORIDA WOMAN CARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2021
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1890 SW HEALTH PKWY STE 303
NAPLES FL
34109-0473
US
IV. Provider business mailing address
PO BOX 9100
BELFAST ME
04915-9100
US
V. Phone/Fax
- Phone: 239-593-0898
- Fax: 239-593-0007
- Phone: 561-300-2410
- Fax: 561-235-7292
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:
ERICA
HERNANDEZ
Title or Position: MANAGER
Credential:
Phone: 561-300-2410