# PAVILION FOR WOMEN'S CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811954340
- **Authorized official:** MR. JOHN M. KIRBY CPA (VP OF FINANCE)
- **Authorized official phone:** (305) 264-5252

## Contact information

- **Practice address:** 8501 SW 124TH AVE, SUITE 211, MIAMI, FL 33183-4627
- **Practice address phone:** (305) 595-6488
- **Practice address fax:** (305) 595-3532
- **Mailing address:** PO BOX 863393, ORLANDO, FL 32886-3393
- **Mailing address phone:** (305) 595-6488
- **Mailing address fax:** (305) 595-3532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/27/2006
- **Last updated:** 06/27/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 269223600 | — | FL |
| 01 | — | 39082 | BC/BS | FL |
| 01 | — | L03000001549 | CORPOORATION | FL |