Provider Demographics
NPI:1932741626
Name:HEALTHY WOMAN WOMEN'S CLINICS OF FLORIDA, INC.
Entity Type:Organization
Organization Name:HEALTHY WOMAN WOMEN'S CLINICS OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIMBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-212-7098
Mailing Address - Street 1:PO BOX 14269
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-4269
Mailing Address - Country:US
Mailing Address - Phone:850-212-7098
Mailing Address - Fax:
Practice Address - Street 1:2410 MAHAN DR STE 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-2305
Practice Address - Country:US
Practice Address - Phone:850-212-7098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable