Healthcare Provider Details

I. General information

NPI: 1730488503
Provider Name (Legal Business Name): CONTEMPORARY WOMENS CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2011
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 GLENWOOD DR SUITE 208
WINTER PARK FL
32792-3328
US

IV. Provider business mailing address

2111 GLENWOOD DR SUITE 208
WINTER PARK FL
32792-3328
US

V. Phone/Fax

Practice location:
  • Phone: 407-478-6249
  • Fax: 407-478-6250
Mailing address:
  • Phone: 407-478-6249
  • Fax: 407-478-6250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: PAMELA SNOOK
Title or Position: PRESIDENT/PHYSICIAN
Credential: MD
Phone: 407-478-6249