Provider Demographics
NPI:1831347293
Name:ALL WOMEN'S HEALTH CENTER OF GAINESVILLE, INC.
Entity type:Organization
Organization Name:ALL WOMEN'S HEALTH CENTER OF GAINESVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND CONTRACT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARISELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARENGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-442-0445
Mailing Address - Street 1:2106 DREW ST
Mailing Address - Street 2:STE 103
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3238
Mailing Address - Country:US
Mailing Address - Phone:727-442-0445
Mailing Address - Fax:727-447-3797
Practice Address - Street 1:1135 NW 23RD AVE
Practice Address - Street 2:SUITE N
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-5415
Practice Address - Country:US
Practice Address - Phone:352-378-9191
Practice Address - Fax:352-372-4823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL777207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty