Organization
FWC UROGYNECOOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA HERNANDEZ (DIRECTOR)
(561) 300-2410
Entity
Organization
Contact information
Practice address
621 SE PORT ST LUCIE BLVD # 621-B, PORT SAINT LUCIE, FL 34984-5141
(561) 626-3800
(561) 624-6364
Mailing address
PO BOX 9100, BELFAST, ME 04915-9100
(561) 300-2410
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
05/30/2024
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