MEDICARE: DOCTOR OF WOMEN'S HEALTH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225200000X	Physical Therapy Assistant
3	225X00000X	Occupational Therapist
4	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1508399619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTOR OF WOMEN'S HEALTH LLC

Provider Business Mailing Address
First Line	:	65 E NASA BLVD STE 101
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1961
Country	:	US
Telephone Number	:	321-802-5655
Fax Number	:	321-802-5656

Provider Business Practice Location Address
First Line	:	65 E NASA BLVD STE 101
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1961
Country	:	US
Telephone Number	:	321-802-5655
Fax Number	:	321-802-5656

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. ANTONIA RENEE MCDOWELL
Credential	:	PT, DPT
Telephone Number	:	321-412-6893

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	12/07/2022

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Directions to “DOCTOR OF WOMEN'S HEALTH LLC ” Practice Location

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