Provider Demographics
NPI:1609441039
Name:WOMEN'S CARE FLORIDA LLC
Entity Type:Organization
Organization Name:WOMEN'S CARE FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALISTAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MADLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-286-0033
Mailing Address - Street 1:PO BOX 25317
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5317
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12110 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-2637
Practice Address - Country:US
Practice Address - Phone:904-384-3699
Practice Address - Fax:904-384-8529
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMEN'S CARE FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty