Healthcare Provider Details

I. General information

NPI: 1457925786
Provider Name (Legal Business Name): WOMEN'S CARE FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6606 SIMMONS LOOP
RIVERVIEW FL
33578-9464
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 813-574-1350
  • Fax: 813-574-1360
Mailing address:
  • Phone: 813-286-0033
  • 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: MICHAEL HOLTON
Title or Position: CEO
Credential:
Phone: 813-286-0033