Organization
PAVILION FOR WOMEN'S CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN M. KIRBY CPA (VP OF FINANCE)
(305) 264-5252
Entity
Organization
Contact information
Practice address
8501 SW 124TH AVE, SUITE 211, MIAMI, FL 33183-4627
(305) 595-6488
(305) 595-3532
Mailing address
PO BOX 863393, ORLANDO, FL 32886-3393
(305) 595-6488
(305) 595-3532
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269223600
—
FL
01
—
39082
BC/BS
FL
01
—
L03000001549
CORPOORATION
FL
Enumeration date
04/27/2006
Last updated
06/27/2008
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