Basic Information
| Provider Information | |||||||||
| NPI: | 1770597676 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | M & D CARE, INC. D/B/A WOMEN'S HEALTH CARE | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WOMEN'S HEALTH CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 TAMPA GENERAL CIR | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336063601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132583309 | ||||||||
| FaxNumber: | 8132514454 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 TAMPA GENERAL CIR | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336063601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132583309 | ||||||||
| FaxNumber: | 8132514454 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 12/19/2013 | ||||||||
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| AuthorizedOfficialLastName: | OMEARA | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8132583309 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 94797 | 01 | FL | BCBS FLORIDA | OTHER | 257772100 | 05 | FL | MEDICAID |