Provider Demographics
NPI:1922107812
Name:ST. PETERSBURG WOMAN'S HEALTH CENTER
Entity Type:Organization
Organization Name:ST. PETERSBURG WOMAN'S HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAUERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-381-6620
Mailing Address - Street 1:3401 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1540
Mailing Address - Country:US
Mailing Address - Phone:727-381-6620
Mailing Address - Fax:727-341-0409
Practice Address - Street 1:3401 66TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1540
Practice Address - Country:US
Practice Address - Phone:727-381-6620
Practice Address - Fax:727-341-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL52765CMedicare ID - Type Unspecified