Healthcare Provider Details

I. General information

NPI: 1609441039
Provider Name (Legal Business Name): WOMEN'S CARE FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 OSCEOLA ELEMENTARY RD STE A
ST AUGUSTINE FL
32084-5942
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-9898
  • Fax: 888-815-1206
Mailing address:
  • Phone:
  • 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: DESIRA DAIL
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 813-533-2906