Provider Demographics
NPI:1235678756
Name:PREMIER WOMEN'S CARE OB/GYN PLLC
Entity Type:Organization
Organization Name:PREMIER WOMEN'S CARE OB/GYN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:MOHAN
Authorized Official - Last Name:RAMCHANDANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-488-2702
Mailing Address - Street 1:2250 OSPREY BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-4340
Mailing Address - Country:US
Mailing Address - Phone:888-488-2702
Mailing Address - Fax:888-235-9876
Practice Address - Street 1:2250 OSPREY BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-4340
Practice Address - Country:US
Practice Address - Phone:888-488-2702
Practice Address - Fax:888-235-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125157207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8023183OtherCIGNA
FLH65501OtherUPIN