NPIMap

Organization Active NPI

FWC Urogynecology, LLC

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Jacksonville, FL
National Provider Identifier
1962074070
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
Legal business name
FWC UROGYNECOLOGY, LLC
Practice address
6885 Belfort Oaks PL Ste 110
Jacksonville, FL 32216-6281
Phone
(904) 652-0373
Fax
(904) 652-0378
NPI assigned
Jul 16, 2021
Organization subpart
Yes
Parent organization
FWC UROGYNECOLOGY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 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 (Urology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2088F0040X Primary

Addresses

Primary practice location

6885 Belfort Oaks PL Ste 110
Jacksonville, FL 32216-6281

Mailing address

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

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1962074070",
    "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": "6885 BELFORT OAKS PL STE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166281",
            "telephone_number": "904-652-0373",
            "fax_number": "904-652-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FWC UROGYNECOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FWC UROGYNECOLOGY, LLC",
        "enumeration_date": "2021-07-16",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "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": "2088F0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.