NPIMap

Organization Active NPI

FWC Urogynecology, LLC

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Port St Lucie, FL
National Provider Identifier
1447906987
Registry record updated Feb 23, 2022
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
10521 SW Village Center Dr Ste 101
Port St Lucie, FL 34987-1930
Phone
(561) 626-3800
Fax
(561) 624-6364
NPI assigned
Feb 23, 2022
Last updated
Feb 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FWC UROGYNECOLOGY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X NU Primary

Addresses

Primary practice location

10521 SW Village Center Dr Ste 101
Port St Lucie, FL 34987-1930

Mailing address

PO Box 5556
Belfast, ME 04915-5500
Phone (561) 300-2410

National Provider Directory

National Provider Directory
Tax ID family
Orlando Urogynecology LLC31 organizations share this tax ID, including this one
Part of
Orlando Urogynecology LLC

Other organizations with this tax ID 30

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

View all 30

Locations

3230 Forum Blvd
Fort Myers, FL 33905
Phone (239) 432-5858

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1447906987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5556",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155500",
            "telephone_number": "561-300-2410",
            "fax_number": "561-235-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 SW VILLAGE CENTER DR STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349871930",
            "telephone_number": "561-626-3800",
            "fax_number": "561-624-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FWC UROGYNECOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FWC UROGYNECOLOGY, LLC",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-300-2410"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.