Provider Demographics
NPI:1629316013
Name:OPTIMAL WOMENS HEALTH CARE PA
Entity Type:Organization
Organization Name:OPTIMAL WOMENS HEALTH CARE PA
Other - Org Name:OPTIMAL WOMENS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELEANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-956-7685
Mailing Address - Street 1:PO BOX 46386
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33646-0104
Mailing Address - Country:US
Mailing Address - Phone:813-956-7685
Mailing Address - Fax:
Practice Address - Street 1:5516 HANLEY RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4904
Practice Address - Country:US
Practice Address - Phone:813-885-1418
Practice Address - Fax:813-886-6731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 90667207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty