Provider Demographics
NPI:1255305645
Name:NORTH FLORIDA WOMENS PHYSICIANS P A
Entity Type:Organization
Organization Name:NORTH FLORIDA WOMENS PHYSICIANS P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-332-7222
Mailing Address - Street 1:6440 W NEWBERRY RD
Mailing Address - Street 2:STE 508
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4381
Mailing Address - Country:US
Mailing Address - Phone:352-332-7222
Mailing Address - Fax:352-332-7330
Practice Address - Street 1:6440 W NEWBERRY RD
Practice Address - Street 2:SUITE 508
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4381
Practice Address - Country:US
Practice Address - Phone:352-332-7222
Practice Address - Fax:352-332-7330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261478200Medicaid
24446Medicare ID - Type Unspecified