Provider Demographics
NPI:1730488503
Name:CONTEMPORARY WOMENS CARE PA
Entity type:Organization
Organization Name:CONTEMPORARY WOMENS CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-478-6249
Mailing Address - Street 1:2111 GLENWOOD DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3328
Mailing Address - Country:US
Mailing Address - Phone:407-478-6249
Mailing Address - Fax:407-478-6250
Practice Address - Street 1:2111 GLENWOOD DR
Practice Address - Street 2:SUITE 208
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3328
Practice Address - Country:US
Practice Address - Phone:407-478-6249
Practice Address - Fax:407-478-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-20
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEY845AMedicare PIN