MEDICARE: FLORIDA WOMAN CARE ,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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1700715497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA WOMAN CARE ,LLC

Provider Business Mailing Address
First Line	:	5801 POSTAL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44181-2184
Country	:	US
Telephone Number	:	561-300-2410
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 SE HILLMOOR DR STE 101
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7577
Country	:	US
Telephone Number	:	772-288-2992
Fax Number	:	772-288-2999

Authorized Official
Title or Position	:	ENROLLMENT
Name	:	TAMMY WALKER
Credential	:
Telephone Number	:	561-300-2410

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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