NPIMap

Organization Active NPI

FWC Urogynecology, LLC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Bradenton, FL
National Provider Identifier
1063330587
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
Legal business name
FWC UROGYNECOLOGY, LLC
Practice address
4764 E State Road 64
Bradenton, FL 34208-9058
Phone
(941) 265-8646
NPI assigned
Jul 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tammy Walker
Title
Enrollment
Phone
(561) 300-2410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VF0040X Primary

Addresses

Primary practice location

4764 E State Road 64
Bradenton, FL 34208-9058

Mailing address

PO Box 818018
Cleveland, OH 44181-8018
Phone (561) 300-2410

National Provider Directory

National Provider Directory
Tax ID family
FWC Urogynecology LLC31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1783641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1063330587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818018",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441818018",
            "telephone_number": "561-300-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4764 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342089058",
            "telephone_number": "941-265-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FWC UROGYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-10",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "ENROLLMENT",
        "authorized_official_telephone_number": "561-300-2410"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.