Provider Demographics
NPI:1336174333
Name:ALPHACENTER FOR WOMENS HEALTH INC
Entity Type:Organization
Organization Name:ALPHACENTER FOR WOMENS HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARMELITA
Authorized Official - Middle Name:OCAMPO
Authorized Official - Last Name:NICDAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-931-3003
Mailing Address - Street 1:720 WEST OAK ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741
Mailing Address - Country:US
Mailing Address - Phone:407-931-3003
Mailing Address - Fax:407-944-9070
Practice Address - Street 1:720 WEST OAK ST
Practice Address - Street 2:SUITE 302
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-931-3003
Practice Address - Fax:407-944-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME20377207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D55552Medicare UPIN
49028ZMedicare ID - Type Unspecified