Healthcare Provider Details
I. General information
NPI: 1003482811
Provider Name (Legal Business Name): FLORIDA WOMAN CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2021
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2801 SE 1ST AVE STE 101
OCALA FL
34471-0478
US
IV. Provider business mailing address
PO BOX 9100
BELFAST ME
04915-9100
US
V. Phone/Fax
- Phone: 352-690-6300
- Fax: 352-690-6802
- Phone: 561-300-2410
- Fax: 561-235-7292
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VF0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
MATTHEW
SUDBURY
Title or Position: PRESIDENT
Credential:
Phone: 941-745-5115