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General NPI Number Information
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NPI Number | 1962454132
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Entity Type | Organization
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Legal Business Name | WOMENS WELLNESS CENTER OF SOUTH FLORIDA LLC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 3850 COCONUT CREEK PKWY SUITE 1
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City | COCONUT CREEK
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State | FL
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Zip | 33066-1600
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Country | US
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Telephone | 954-984-8892
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Fax | 954-984-8810
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Provider Business Mailing Address
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Address Line | 3850 COCONUT CREEK PKWY SUITE 1
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City | COCONUT CREEK
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State | FL
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Zip | 33066-1600
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Country | US
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Telephone | 954-984-8892
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Fax | 954-984-8810
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TARA ANN SOLOMON
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Credential | MD
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Telephone | 954-984-8892
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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 | FL
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