Provider Demographics
NPI:1770702284
Name:PRESIDENTIAL WOMENS CENTER INC
Entity type:Organization
Organization Name:PRESIDENTIAL WOMENS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MONA
Authorized Official - Middle Name:S
Authorized Official - Last Name:REIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-686-3859
Mailing Address - Street 1:100 NORTHPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1906
Mailing Address - Country:US
Mailing Address - Phone:561-686-3859
Mailing Address - Fax:561-478-3963
Practice Address - Street 1:100 NORTHPOINT PKWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1906
Practice Address - Country:US
Practice Address - Phone:561-686-3859
Practice Address - Fax:561-478-3963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL863261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL39040Medicare ID - Type Unspecified