MEDICARE: DEVOTED TO WOMEN, P.A.

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	207VX0000X	Obstetrics Physician	45778	FL

General Provider Information

NPI Number	:	1992706949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEVOTED TO WOMEN, P.A.

Provider Business Mailing Address
First Line	:	661 EAST ALTAMONTE DRIVE
Second Line	:	SUITE 224
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5102
Country	:	US
Telephone Number	:	407-830-9000
Fax Number	:	407-830-9040

Provider Business Practice Location Address
First Line	:	661 EAST ALTAMONTE DRIVE
Second Line	:	SUITE 224
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5102
Country	:	US
Telephone Number	:	407-830-9000
Fax Number	:	407-830-9040

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. CRAIG NORMAN DEFREESE
Credential	:	M.D.
Telephone Number	:	407-830-9000

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	11/16/2007

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