Provider Demographics
NPI:1750672143
Name:FLORIDA WOMAN CARE, LLC
Entity Type:Organization
Organization Name:FLORIDA WOMAN CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:KONSKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-300-2410
Mailing Address - Street 1:4205 W ATLANTIC AVE
Mailing Address - Street 2:SUITE C-405
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3901
Mailing Address - Country:US
Mailing Address - Phone:561-300-2410
Mailing Address - Fax:561-495-5408
Practice Address - Street 1:32801 US 19 N
Practice Address - Street 2:SUITE 100
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3105
Practice Address - Country:US
Practice Address - Phone:727-942-7000
Practice Address - Fax:727-938-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty