MEDICARE: FEMALE HEALTH GROUP LLC

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	207VG0400X	Gynecology Physician	ME26937	FL

General Provider Information

NPI Number	:	1093139784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEMALE HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	1700 N UNIVERSITY DR
Second Line	:	SUITE 202
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8970
Country	:	US
Telephone Number	:	954-592-1626
Fax Number	:	954-755-8075

Provider Business Practice Location Address
First Line	:	1700 N UNIVERSITY DR
Second Line	:	SUITE 202
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8970
Country	:	US
Telephone Number	:	954-592-1626
Fax Number	:	954-755-8075

Authorized Official
Title or Position	:	CEO
Name	:	DR. MYLISSA GRABER
Credential	:	M.D.
Telephone Number	:	954-592-1626

Provider Enumeration Date	:	02/14/2014
Last Update Date	:	02/14/2014

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