Healthcare Provider Details
I. General information
NPI: 1386824704
Provider Name (Legal Business Name): VILLAGE WOMEN'S HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/14/2007
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2247 PALM BEACH LAKES BLVD SUITE 206
WEST PALM BEACH FL
33409-3470
US
IV. Provider business mailing address
3783 PRESTWICK CIRCLE
PALM BEACH GARDENS FL
33418-0000
US
V. Phone/Fax
- Phone: 561-712-0688
- Fax: 561-471-9186
- Phone: 561-712-0688
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
KATIA
TERESA
LAREMONT
Title or Position: OWNER
Credential: M.D.
Phone: 561-712-0688