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General NPI Number Information
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NPI Number | 1194053611
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Entity Type | Organization
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Legal Business Name | HEALTHY CHOICE OB-GYN, P.A.
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 11/20/2009
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Provider Practice Location Address
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Address Line | 400 W WOODWARD AVE
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City | EUSTIS
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State | FL
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Zip | 32726-4555
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Country | US
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Telephone | 352-483-3730
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Fax | 352-483-3355
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Provider Business Mailing Address
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Address Line | 400 W WOODWARD AVE
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City | EUSTIS
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State | FL
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Zip | 32726-4555
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Country | US
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Telephone | 352-483-3730
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Fax | 352-483-3355
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Authorized Official
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Title or Position | OWNER
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Name | DR. WENDY S. PERROTT
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Credential | M.D.
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Telephone | 352-483-3730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0066695
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License Number State | FL
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