Healthcare Provider Details

I. General information

NPI: 1124561402
Provider Name (Legal Business Name): SELECT WOMEN'S HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 11/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N FLAGLER DR SUITE #6400
WEST PALM BEACH FL
33401-3404
US

IV. Provider business mailing address

1411 N FLAGLER DR SUITE #6400
WEST PALM BEACH FL
33401-3404
US

V. Phone/Fax

Practice location:
  • Phone: 561-855-8187
  • Fax: 561-296-1838
Mailing address:
  • Phone: 561-855-8187
  • Fax: 561-296-1838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP9265135
License Number StateFL

VIII. Authorized Official

Name: PATRICK PHILBIN
Title or Position: OWNER
Credential:
Phone: 216-952-2252