Provider Demographics
NPI:1245410026
Name:WOMANCARE OF THE KEYS INC
Entity Type:Organization
Organization Name:WOMANCARE OF THE KEYS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-293-6991
Mailing Address - Street 1:5450 MCDONALD AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-5906
Mailing Address - Country:US
Mailing Address - Phone:305-293-6991
Mailing Address - Fax:305-293-9896
Practice Address - Street 1:5450 MCDONALD AVE STE 4
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-5906
Practice Address - Country:US
Practice Address - Phone:305-293-6991
Practice Address - Fax:305-293-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74691207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2455Medicare PIN