Healthcare Provider Details
I. General information
NPI: 1851537831
Provider Name (Legal Business Name): WOMENS CARE FLORIDA LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/23/2008
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2102 TRINITY OAKS BLVD STE 171
TRINITY FL
34655-4409
US
IV. Provider business mailing address
PO BOX 748817
ATLANTA GA
30374-8817
US
V. Phone/Fax
- Phone: 727-376-7734
- Fax: 727-408-5336
- Phone: 813-286-0033
- Fax: 813-282-1806
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VF0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| 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