Healthcare Provider Details

I. General information

NPI: 1588965024
Provider Name (Legal Business Name): KOTZEN CENTER FOR WOMENS HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2010
Last Update Date: 10/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4280 PROFESSIONAL CENTER DR SUITE 300
PALM BEACH GARDENS FL
33410-4280
US

IV. Provider business mailing address

4280 PROFESSIONAL CENTER DR SUITE 300
PALM BEACH GARDENS FL
33410-4280
US

V. Phone/Fax

Practice location:
  • Phone: 561-837-9880
  • Fax: 561-837-9884
Mailing address:
  • Phone: 561-837-9880
  • Fax: 561-837-9884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME39811
License Number StateFL

VIII. Authorized Official

Name: KAREN BARLOW
Title or Position: PRESIDENT, JUPITER PROF DEVELOPMENT
Credential:
Phone: 561-748-2889