NPIMap

Organization Active NPI

Lifechoices Women'S Care, Inc.

  • Family Medicine Physician
  • Lutz, FL
National Provider Identifier
1891240503
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFECHOICES WOMEN'S CARE, INC.
Practice address
18560 N Dale Mabry Hwy
Lutz, FL 33548-7900
Phone
(813) 948-7734
Fax
(813) 769-9752
NPI assigned
Aug 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Vanessa Acevedo
Title
Clinic Director
Phone
(813) 948-7734

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X

Addresses

Primary practice location

18560 N Dale Mabry Hwy
Lutz, FL 33548-7900

Mailing address

18560 N Dale Mabry Hwy
Lutz, FL 33548-7900
Phone (813) 948-7734

Other identifiers 1

IdentifierTypeStateIssuer
107332100MedicaidFL

Other names 1

  • LifeChoices Family Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190612000077 FL Part B Supplier - Clinic/Group Practice 1153654819 Receives reassigned benefits from 1 practitioner
Practice locations: Lutz, FL

National Provider Directory

National Provider Directory

Locations

18560 N Dale Mabry Hwy
Lutz, FL 33548
Phone (813) 948-7734

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1891240503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18560 N DALE MABRY HWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335487900",
            "telephone_number": "813-948-7734",
            "fax_number": "813-769-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18560 N DALE MABRY HWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335487900",
            "telephone_number": "813-948-7734",
            "fax_number": "813-769-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECHOICES WOMEN'S CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-23",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "813-948-7734"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107332100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeChoices Family Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.