Provider Demographics
NPI:1093574105
Name:GAINESVILLE WOMAN CARE, LLC
Entity Type:Organization
Organization Name:GAINESVILLE WOMAN CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-372-1664
Mailing Address - Street 1:1233 NW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4154
Mailing Address - Country:US
Mailing Address - Phone:352-372-1664
Mailing Address - Fax:352-372-3222
Practice Address - Street 1:1233 NW 10TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4154
Practice Address - Country:US
Practice Address - Phone:352-372-1664
Practice Address - Fax:352-372-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility