Provider Demographics
NPI:1215173240
Name:WOMENS CARE FLORIDA LLC
Entity type:Organization
Organization Name:WOMENS CARE FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-286-2033
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:515 S KINGS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5921
Practice Address - Country:US
Practice Address - Phone:813-681-9171
Practice Address - Fax:813-681-7580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMEN'S CARE FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-22
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21238Medicare PIN
FLCG4039Medicare PIN
FLDE7727Medicare PIN
FLCN3786Medicare PIN