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General NPI Number Information
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NPI Number | 1306097829
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Entity Type | Organization
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Legal Business Name | WOMEN'S CONTEMPORARY HEALTH CENTER, PLLC
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 6150 DIAMOND CENTRE CT BUILDING 400
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City | FORT MYERS
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State | FL
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Zip | 33912-4365
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Country | US
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Telephone | 239-561-9191
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Fax | 239-561-9188
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Provider Business Mailing Address
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Address Line | 6150 DIAMOND CENTRE CT BUILDING 400
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City | FORT MYERS
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State | FL
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Zip | 33912-4365
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Country | US
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Telephone | 239-561-9191
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Fax | 239-561-9188
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | EILEEN M KOZAK
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Credential |
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Telephone | 239-561-9191
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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 | ME0045181
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License Number State | FL
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