1023256096 NPI number — WOMENS HEALTH ASSOCIATES OF HERNANDO PLC

Table of content: VICTORIA KNIGHTEN (NPI 1912620519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023256096 NPI number — WOMENS HEALTH ASSOCIATES OF HERNANDO PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOMENS HEALTH ASSOCIATES OF HERNANDO PLC
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:
1023256096
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5189
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING HILL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34611-5189
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-556-5241
Provider Business Mailing Address Fax Number:
352-556-5244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11373 CORTEZ BLVD
Provider Second Line Business Practice Location Address:
SUITE 408
Provider Business Practice Location Address City Name:
BROOKSVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34613-5414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-556-5241
Provider Business Practice Location Address Fax Number:
352-556-5244
Provider Enumeration Date:
01/29/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MARLER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
352-556-5241

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X , with the licence number:  ME 74253 , 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: ME 74253 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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