Provider Demographics
NPI:1245265479
Name:WOMEN'S CARE CENTER OF PASCO
Entity type:Organization
Organization Name:WOMEN'S CARE CENTER OF PASCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCKENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-848-6474
Mailing Address - Street 1:5422 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-3948
Mailing Address - Country:US
Mailing Address - Phone:727-849-1659
Mailing Address - Fax:727-842-3627
Practice Address - Street 1:5422 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3948
Practice Address - Country:US
Practice Address - Phone:727-849-1659
Practice Address - Fax:727-842-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1390Medicare ID - Type Unspecified
FLK1390Medicare UPIN