Provider Demographics
NPI:1477683738
Name:SOUTH FLORIDA WOMENS HEALTH ASSOCIATES INC
Entity Type:Organization
Organization Name:SOUTH FLORIDA WOMENS HEALTH ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-427-4966
Mailing Address - Street 1:2345 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1110
Mailing Address - Country:US
Mailing Address - Phone:954-427-4966
Mailing Address - Fax:954-427-6517
Practice Address - Street 1:2345 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1110
Practice Address - Country:US
Practice Address - Phone:954-427-4966
Practice Address - Fax:954-427-6517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40513174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21912Medicare PIN