Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | OSO005926 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | OS-5926 | FL |
N | 207VG0400X | Gynecologist | OS0005926 | FL |
NPI | 1649268137 |
---|---|
Provider Name | Dr. Eileen F Farwick |
First Address | Ocoee, FL 34761-3498 |
Second Address | Ocoee, FL 34761-3498 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 27/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
266246900 | (05) | FL |
4549601 | AETNA (01) | |
80913 | BLUE CROSS BLUE SHIELD (01) | |
E97807 | (02) | FL |