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General NPI Number Information
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NPI Number | 1508903030
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Entity Type | Organization
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Legal Business Name | WOMENS SPECIAL CARE P A
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 3900 UNIVERSITY BLVD S
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4313
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Country | US
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Telephone | 904-858-1574
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Fax | 904-398-4263
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Provider Business Mailing Address
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Address Line | 7803 HOLLYRIDGE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7135
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Country | US
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Telephone | 904-858-1574
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Fax | 904-398-4263
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Authorized Official
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Title or Position | MD
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Name | SUNWOOK KIM-ASHCHI
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Credential |
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Telephone | 904-858-1574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME77123
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License Number State | FL
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