Healthcare Provider Details

I. General information

NPI: 1215297577
Provider Name (Legal Business Name): WOMEN'S HEALTH / NATURAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 05/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12944 W DIXIE HWY
NORTH MIAMI FL
33161-4810
US

IV. Provider business mailing address

12944 WEST DIXIE HIGHWAY
NORTH MIAMI FL
33161
US

V. Phone/Fax

Practice location:
  • Phone: 305-895-4900
  • Fax:
Mailing address:
  • Phone: 305-895-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW258
License Number StateFL

VIII. Authorized Official

Name: DR. JOSEPH PRICE DESTINOBLES
Title or Position: MIDWIFERY
Credential:
Phone: 305-895-4900