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NPI Code Detail

MEDICARE: EXODUS WOMEN'S CENTER, INC.

MEDICARE: EXODUS WOMEN'S CENTER, INC.
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
1207V00000XObstetrics & Gynecology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699108183
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXODUS WOMEN'S CENTER, INC.
Provider Business Mailing Address
First Line : 888 S PARSONS AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-6007
Country : US
Telephone Number : 813-684-2229
Fax Number : 813-654-1384
Provider Business Practice Location Address
First Line : 1525 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3203
Country : US
Telephone Number : 813-684-2229
Fax Number : 813-654-1384
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : MS. LINDA S. MAYO
Credential :
Telephone Number : 813-684-2229
Provider Enumeration Date : 08/20/2013
Last Update Date : 06/02/2019

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Directions to “EXODUS WOMEN'S CENTER, INC. ” Practice Location

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