Healthcare Provider Details

I. General information

NPI: 1265796957
Provider Name (Legal Business Name): LAKELAND MIDWIFERY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 03/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 S FLORIDA AVE
LAKELAND FL
33803-2655
US

IV. Provider business mailing address

1923 S FLORIDA AVE
LAKELAND FL
33803-2655
US

V. Phone/Fax

Practice location:
  • Phone: 863-683-4663
  • Fax: 888-853-9293
Mailing address:
  • Phone: 863-683-4663
  • Fax: 888-853-9293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW175
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW92
License Number StateFL

VIII. Authorized Official

Name: MS. MARIANNE POWER
Title or Position: OWNER
Credential: LM
Phone: 863-660-0048