Basic Information
| Provider Information | |||||||||
| NPI: | 1235296153 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JUST LADIES HEALTHCARE, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1304 N LAWNWOOD CIR | ||||||||
| Address2: | |||||||||
| City: | FORT PIERCE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349504884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7724896636 | ||||||||
| FaxNumber: | 7724895749 | ||||||||
| Practice Location | |||||||||
| Address1: | 1304 N LAWNWOOD CIR | ||||||||
| Address2: | |||||||||
| City: | FORT PIERCE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349504884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7724896636 | ||||||||
| FaxNumber: | 7724895749 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LOMAX-HOMIER | ||||||||
| AuthorizedOfficialFirstName: | JULIETTE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7724896636 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | ME0048841 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.