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General NPI Number Information
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NPI Number | 1700455367
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Entity Type | Organization
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Legal Business Name | FLORIDA WOMAN CARE LLC
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 1510 RIVERPLACE BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-9017
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Country | US
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Telephone | 904-346-0050
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Fax | 904-346-0080
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Provider Business Mailing Address
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Address Line | PO BOX 9100
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City | BELFAST
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State | ME
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Zip | 04915-9100
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Country | US
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Telephone | 561-300-2410
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Fax | 561-235-7292
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Authorized Official
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Title or Position | MANAGER
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Name | ERICA HERNANDEZ
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Credential |
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Telephone | 561-300-2410
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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 |
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License Number State |
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