Provider Demographics
NPI:1902074610
Name:WESLEY CHAPEL WOMEN'S CARE INC
Entity Type:Organization
Organization Name:WESLEY CHAPEL WOMEN'S CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRAJ
Authorized Official - Middle Name:VANRAJ
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-929-4999
Mailing Address - Street 1:20321 MERRY OAK AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3645
Mailing Address - Country:US
Mailing Address - Phone:813-929-4999
Mailing Address - Fax:813-454-1114
Practice Address - Street 1:2734 WINDGUARD CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7362
Practice Address - Country:US
Practice Address - Phone:813-929-4999
Practice Address - Fax:813-454-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95114207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277341400Medicaid
FL277341400Medicaid