Healthcare Provider Details

I. General information

NPI: 1073583761
Provider Name (Legal Business Name): EILEEN F. FARWICK, D.O.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 05/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR SUITE 386
OCOEE FL
34761-3498
US

IV. Provider business mailing address

10000 W COLONIAL DR STE 386
OCOEE FL
34761-3498
US

V. Phone/Fax

Practice location:
  • Phone: 407-296-1990
  • Fax: 407-296-1992
Mailing address:
  • Phone: 407-296-1990
  • Fax: 407-296-1992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP 9297245
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS0005926
License Number StateFL

VIII. Authorized Official

Name: DR. EILEEN F FARWICK
Title or Position: PRESIDENT
Credential: DO
Phone: 407-296-1990