Provider Demographics
NPI:1013680792
Name:FWC PERINATAL, LLC
Entity Type:Organization
Organization Name:FWC PERINATAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-300-2410
Mailing Address - Street 1:PO BOX 5558
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-5500
Mailing Address - Country:US
Mailing Address - Phone:561-275-7608
Mailing Address - Fax:561-835-4038
Practice Address - Street 1:770 NORTHPOINT PKWY STE 100
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1901
Practice Address - Country:US
Practice Address - Phone:561-655-3331
Practice Address - Fax:561-655-3744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-28
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty