=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255305645
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH FLORIDA WOMENS PHYSICIANS P A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2006
-----------------------------------------------------
Last Update Date | 11/03/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6440 W NEWBERRY RD SUITE 508
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32605-4381
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-332-7222
-----------------------------------------------------
Fax | 352-332-7330
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6440 W NEWBERRY RD STE 508
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32605-4381
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-332-7222
-----------------------------------------------------
Fax | 352-332-7330
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KAREN HARRIS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 352-332-7222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------