Provider Demographics
NPI:1316154610
Name:FLORIDA WOMAN CARE,LLC
Entity type:Organization
Organization Name:FLORIDA WOMAN CARE,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:PILLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-383-4966
Mailing Address - Street 1:18450 US HIGHWAY 441 # C
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6707
Mailing Address - Country:US
Mailing Address - Phone:352-383-4966
Mailing Address - Fax:352-383-2001
Practice Address - Street 1:18450 US HIGHWAY 441 #C
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6707
Practice Address - Country:US
Practice Address - Phone:352-383-4966
Practice Address - Fax:352-383-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9192551363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD54365Medicare UPIN
FL24974Medicare ID - Type Unspecified
FLE3491ZMedicare UPIN