Provider Demographics
NPI:1649268137
Name:FARWICK, EILEEN F (DO)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:F
Last Name:FARWICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:STE 386
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3498
Mailing Address - Country:US
Mailing Address - Phone:407-296-1990
Mailing Address - Fax:407-296-1992
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:SUITE 386
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3498
Practice Address - Country:US
Practice Address - Phone:407-296-1990
Practice Address - Fax:407-296-1992
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOSO005926207V00000X
FLOS0005926207VG0400X
FLOS-5926207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266246900Medicaid
4549601OtherAETNA
80913OtherBLUE CROSS BLUE SHIELD
FLE97807Medicare UPIN
FL266246900Medicaid
FL80913YMedicare ID - Type Unspecified
FL80913XMedicare PIN