Provider Demographics
NPI:1518132133
Name:DR .EDWARD W. HALPREN D.O. P.A.
Entity Type:Organization
Organization Name:DR .EDWARD W. HALPREN D.O. P.A.
Other - Org Name:GULF COAST WOMEN'S CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:HALPREN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-561-2200
Mailing Address - Street 1:14271 METROPOLIS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4302
Mailing Address - Country:US
Mailing Address - Phone:239-561-2200
Mailing Address - Fax:239-561-2491
Practice Address - Street 1:14271 METROPOLIS AVE STE B
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4302
Practice Address - Country:US
Practice Address - Phone:239-561-2200
Practice Address - Fax:239-561-2491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005272207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047104600Medicaid
FL047104600Medicaid