Healthcare Provider Details
I. General information
NPI: 1598279614
Provider Name (Legal Business Name): JOCELYN MILANES IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/28/2017
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 NW 95TH ST
MIAMI FL
33150-2038
US
IV. Provider business mailing address
2458 SW 106TH AVE
MIRAMAR FL
33025-3980
US
V. Phone/Fax
- Phone: 305-835-6000
- Fax:
- Phone: 305-310-0664
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174N00000X |
| Taxonomy | Lactation Consultant (Non-RN) |
| License Number | L33003 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: