MEDICARE: WOMEN'S CARE OF CLERMONT PA

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	174400000X	Specialist	ME81410	FL

General Provider Information

NPI Number	:	1760596431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMEN'S CARE OF CLERMONT PA

Provider Business Mailing Address
First Line	:	1725 E HIGHWAY 50
Second Line	:	SUITE B
City	:	CLERMONT
State	:	FL
Zip	:	34711-5188
Country	:	US
Telephone Number	:	352-243-6686
Fax Number	:	352-243-2414

Provider Business Practice Location Address
First Line	:	1725 E HIGHWAY 50
Second Line	:	SUITE B
City	:	CLERMONT
State	:	FL
Zip	:	34711-5188
Country	:	US
Telephone Number	:	352-243-6686
Fax Number	:	352-243-2414

Authorized Official
Title or Position	:	OWNER
Name	:	SHELLEY COLEMAN GLOVER
Credential	:	MD
Telephone Number	:	352-243-6686

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	06/26/2012

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Directions to “WOMEN'S CARE OF CLERMONT PA ” Practice Location

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