1598087231 NPI number — WOMEN'S HEALTHCARE OF ORLANDO, PA

Table of content: (NPI 1598087231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598087231 NPI number — WOMEN'S HEALTHCARE OF ORLANDO, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOMEN'S HEALTHCARE OF ORLANDO, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598087231
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 781444
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32878-1444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-453-2072
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3701 AVALON PARK WEST BLVD
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32828-7303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-453-2072
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
DUNN
Authorized Official First Name:
INGRID
Authorized Official Middle Name:
PATRICIA
Authorized Official Title or Position:
SOLO PRACTITIONER
Authorized Official Telephone Number:
407-453-2072

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  ME 104799 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CX948Z . This is a "ASSOCIATED INDIVIDUAL MEDICARE NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 002284400 . This is a "INDIVIDUAL MEDICAID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: GROUP CX949A . This is a "GROUP MEDICARE NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1073735270 . This is a "INDIVIDUAL PROVIDER NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 001933000 . This is a "GROUP MEDICAID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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