MEDICARE: FOR WOMEN P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME0062545	FL

General Provider Information

NPI Number	:	1053470724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOR WOMEN P.A.

Provider Business Mailing Address
First Line	:	1570 COLONIAL BLVD
Second Line	:	SUITE A
City	:	FORT MYERS
State	:	FL
Zip	:	33907
Country	:	US
Telephone Number	:	239-939-2229
Fax Number	:	239-939-0399

Provider Business Practice Location Address
First Line	:	1570 COLONIAL BLVD
Second Line	:	SUITE A
City	:	FORT MYERS
State	:	FL
Zip	:	33907
Country	:	US
Telephone Number	:	239-939-2229
Fax Number	:	239-939-0399

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JANE AILENE DANIEL
Credential	:	M.D.
Telephone Number	:	239-939-2229

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	08/22/2020

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