NPIMap

Organization Active NPI

Exodus Women'S Center, Inc.

  • Obstetrics & Gynecology Physician
  • Lakeland, FL
National Provider Identifier
1336306372
Registry record updated Jun 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
EXODUS WOMEN'S CENTER, INC.
Practice address
215 Imperial Blvd Ste B2
Lakeland, FL 33803-4689
Phone
(813) 684-2229
NPI assigned
May 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2019

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

Authorized official

Name
Ms. Linda S. Mayo
Title
Director of Operations
Phone
(813) 684-2229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

215 Imperial Blvd Ste B2
Lakeland, FL 33803-4689

Mailing address

888 S Parsons Ave
Brandon, FL 33511-6007
Phone (813) 684-2229

Other identifiers 1

IdentifierTypeStateIssuer
057571220MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Exodus Women'S Center Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1901 Manatee Ave W
Bradenton, FL 34205
Phone (941) 747-2229

2701 W Mlk Blvd
Tampa, FL 33607
Phone (813) 738-6690

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559433600000",
    "number": "1336306372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 S PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116007",
            "telephone_number": "813-684-2229",
            "fax_number": "813-654-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 IMPERIAL BLVD STE B2",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034689",
            "telephone_number": "813-684-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS WOMEN'S CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2019-06-02",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "813-684-2229",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057571220",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2019; 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.