Healthcare Provider Details

I. General information

NPI: 1659560720
Provider Name (Legal Business Name): BELLYMAMA MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 NW 51ST ST
MIAMI FL
33127-2160
US

IV. Provider business mailing address

315 NW 51ST ST
MIAMI FL
33127-2160
US

V. Phone/Fax

Practice location:
  • Phone: 305-308-5900
  • Fax: 305-677-9097
Mailing address:
  • Phone: 305-308-5900
  • Fax: 305-677-9097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW102
License Number StateFL

VIII. Authorized Official

Name: MISS CORINA MAE FITCH
Title or Position: OWNER
Credential: LM, CPM
Phone: 305-308-5900