Provider Demographics
NPI:1760466510
Name:WOMENS HEALTH CENTER OF CENTRAL FLORIDA LLC
Entity Type:Organization
Organization Name:WOMENS HEALTH CENTER OF CENTRAL FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-523-2117
Mailing Address - Street 1:2000 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4525
Mailing Address - Country:US
Mailing Address - Phone:615-372-5426
Mailing Address - Fax:
Practice Address - Street 1:1319 S INTERNATIONAL PKWY
Practice Address - Street 2:STE 1151
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1408
Practice Address - Country:US
Practice Address - Phone:407-333-1616
Practice Address - Fax:407-333-1617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72899OtherBCBS
FL1068202OtherCAREPLUS
FLDH1316OtherRR MEDICARE
FL000499600Medicaid
FL7303687OtherAETNA
FLSG092581OtherCOVENTRY
FL17457OtherUNIVERSAL
FL30033511OtherHUMANA
FL17457OtherUNIVERSAL
FLAS116ZMedicare PIN