NPIMap

Organization Active NPI

FWC Urogynecoology, LLC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Port Saint Lucie, FL
National Provider Identifier
1194564666
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
Legal business name
FWC UROGYNECOOLOGY, LLC
Practice address
621 SE Port St Lucie Blvd # 621-B
Port Saint Lucie, FL 34984-5141
Phone
(561) 626-3800
Fax
(561) 624-6364
NPI assigned
May 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Erica Hernandez
Title
Director
Phone
(561) 300-2410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VF0040X Primary

Addresses

Primary practice location

621 SE Port St Lucie Blvd # 621-B
Port Saint Lucie, FL 34984-5141

Mailing address

PO Box 9100
Belfast, ME 04915-9100
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

Locations

621 SE Port St Lucie Blvd
#621A
Port St Lucie, FL 34984

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1194564666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9100",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049159100",
            "telephone_number": "561-300-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SE PORT ST LUCIE BLVD # 621-B",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349845141",
            "telephone_number": "561-626-3800",
            "fax_number": "561-624-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FWC UROGYNECOOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-300-2410"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.