Provider Demographics
NPI:1194822361
Name:WOMEN'S CARE FIRST PA
Entity Type:Organization
Organization Name:WOMEN'S CARE FIRST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:B
Authorized Official - Last Name:RASHADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-943-3621
Mailing Address - Street 1:744 W PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-3282
Mailing Address - Country:US
Mailing Address - Phone:386-943-3618
Mailing Address - Fax:386-943-3619
Practice Address - Street 1:744 W PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3282
Practice Address - Country:US
Practice Address - Phone:386-943-3618
Practice Address - Fax:386-943-3619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 93295207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274005200Medicaid
FL274005200Medicaid
FLBA577Medicare PIN
FLK9086Medicare PIN