Healthcare Provider Details
I. General information
NPI: 1013153030
Provider Name (Legal Business Name): WOMENS CARE FLORIDA LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/22/2008
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2809 CORRINE DR
ORLANDO FL
32803-2235
US
IV. Provider business mailing address
PO BOX 748817
ATLANTA GA
30374-8817
US
V. Phone/Fax
- Phone: 407-898-9922
- Fax: 407-898-9944
- Phone: 181-328-6003
- Fax: 813-282-1806
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:
ELLEN
MICHELLE
BOWER
Title or Position: COO
Credential:
Phone: 813-286-2033