Provider Demographics
NPI:1013399427
Name:WOMEN'S HEALTH CARE ST. PETE
Entity Type:Organization
Organization Name:WOMEN'S HEALTH CARE ST. PETE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARFOOT
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, ARNP
Authorized Official - Phone:727-344-1234
Mailing Address - Street 1:6450 38TH AVE N
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1645
Mailing Address - Country:US
Mailing Address - Phone:727-344-1234
Mailing Address - Fax:
Practice Address - Street 1:6450 38TH AVE N
Practice Address - Street 2:SUITE 320
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1645
Practice Address - Country:US
Practice Address - Phone:727-344-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9340919261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNONEOtherNONE