Healthcare Provider Details

I. General information

NPI: 1366376998
Provider Name (Legal Business Name): BIRTH MAMA DOULA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2247 NW 100TH ST
GAINESVILLE FL
32606-4029
US

IV. Provider business mailing address

2247 NW 100TH ST
GAINESVILLE FL
32606-4029
US

V. Phone/Fax

Practice location:
  • Phone: 954-651-4322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE ROMELUS
Title or Position: DOULA
Credential:
Phone: 954-651-4322