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Organization

MODERN TIMES WOMENS CARE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IDALIA TALAVERA M.D. (PRESIDENT)
(954) 921-3090
Entity
Organization

Contact information

Practice address
7050 NW 4TH ST, SUITE 201, PLANTATION, FL 33317-2247
(954) 791-3090
(954) 921-3166
Mailing address
7050 NW 4TH ST, SUITE 201, PLANTATION, FL 33317-2247
(954) 791-3090
(954) 921-3166

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME85186
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
277741000
FL
Enumeration date
11/15/2006
Last updated
03/31/2011
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