Healthcare Provider Details

I. General information

NPI: 1518640317
Provider Name (Legal Business Name): ROWELLS LABOR OF LOVE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 MYRTLE RIDGE RD
LUTZ FL
33549-5632
US

IV. Provider business mailing address

106 MYRTLE RIDGE RD
LUTZ FL
33549-5632
US

V. Phone/Fax

Practice location:
  • Phone: 813-949-1185
  • Fax: 813-949-1162
Mailing address:
  • Phone: 813-949-1185
  • Fax: 813-949-1162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA CROSTON
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 813-949-1185