Healthcare Provider Details

I. General information

NPI: 1962377630
Provider Name (Legal Business Name): FLORIDA WOMAN CARE ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10775 NARCOOSSEE RD STE 200
ORLANDO FL
32832-7177
US

IV. Provider business mailing address

5801 POSTAL RD
CLEVELAND OH
44181-2184
US

V. Phone/Fax

Practice location:
  • Phone: 407-857-2502
  • Fax: 407-857-1855
Mailing address:
  • Phone: 561-300-2410
  • Fax:

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: TAMMY WALKER
Title or Position: ENROLLMENT
Credential:
Phone: 561-300-2410