Provider Demographics
NPI:1518127703
Name:CENTER FOR TOTAL WOMENS HEALTH PA
Entity Type:Organization
Organization Name:CENTER FOR TOTAL WOMENS HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-983-9600
Mailing Address - Street 1:5976 BERRYHILL RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-4009
Mailing Address - Country:US
Mailing Address - Phone:850-983-9600
Mailing Address - Fax:
Practice Address - Street 1:5976 BERRYHILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4009
Practice Address - Country:US
Practice Address - Phone:850-983-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83152207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA878690060AMedicaid
1629061213OtherNPI JOHN WILLIAM ERVIN, M.D.
1629061213OtherNPI JOHN WILLIAM ERVIN, M.D.