Basic Information
| Provider Information | |||||||||
| NPI: | 1407995756 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOMENS CENTER FOR TOTAL HEALTH INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1925 MIZELL AVE | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327924106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076453055 | ||||||||
| FaxNumber: | 4076475125 | ||||||||
| Practice Location | |||||||||
| Address1: | 1925 MIZELL AVE | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327924106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076453055 | ||||||||
| FaxNumber: | 4076475125 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ALBRITTON | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | SPENCER | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4076453055 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.