MEDICARE: GIFT OF LIFE PREGNANCY SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QB0400X	Birthing Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386108801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFT OF LIFE PREGNANCY SERVICES, LLC

Provider Business Mailing Address
First Line	:	5045 SERRY LN
Second Line	:
City	:	PACE
State	:	FL
Zip	:	32571-8858
Country	:	US
Telephone Number	:	561-298-9220
Fax Number	:	850-807-5175

Provider Business Practice Location Address
First Line	:	3518 BROADWAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-4842
Country	:	US
Telephone Number	:	954-383-4198
Fax Number	:	561-429-8267

Authorized Official
Title or Position	:	MIDWIFE
Name	:	MS. MANDY J ROJAS
Credential	:	L.M.
Telephone Number	:	954-383-4198

Provider Enumeration Date	:	01/29/2019
Last Update Date	:	03/21/2025

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