Healthcare Provider Details

I. General information

NPI: 1932866944
Provider Name (Legal Business Name): HOLLYWOOD BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2021
Last Update Date: 11/24/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 HOLLYWOOD BLVD
HOLLYWOOD FL
33020-6703
US

IV. Provider business mailing address

2316 HOLLYWOOD BLVD
HOLLYWOOD FL
33020-6703
US

V. Phone/Fax

Practice location:
  • Phone: 954-925-4499
  • Fax: 954-925-2756
Mailing address:
  • Phone: 954-925-4499
  • Fax: 954-925-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH JO VUERICH
Title or Position: CONTRACTING MANAGER
Credential:
Phone: 978-248-0736