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General NPI Number Information
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NPI Number | 1700130721
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Entity Type | Organization
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Legal Business Name | WOMEN'S HEALTHCARE OF SW FLORIDA, LLC
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 7890 SUMMERLIN LAKES DR SUITE 3
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City | FORT MYERS
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State | FL
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Zip | 33907-1851
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Country | US
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Telephone | 239-939-1999
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Fax | 239-939-4935
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Provider Business Mailing Address
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Address Line | 7890 SUMMERLIN LAKES DR SUITE 3
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City | FORT MYERS
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State | FL
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Zip | 33907-1851
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Country | US
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Telephone | 239-939-1999
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Fax | 239-939-4935
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Authorized Official
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Title or Position | OFFICER
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Name | MS. CARYLE LYNE CLYATT
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Credential | ARNP
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Telephone | 239-939-1999
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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 | ME92164
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME59299
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License Number State | FL
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