Healthcare Provider Details

I. General information

NPI: 1629515341
Provider Name (Legal Business Name): AMBER MARIE HOPCROFT CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2017
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 OUTER RD STE A
ORLANDO FL
32814-6652
US

IV. Provider business mailing address

867 OUTER RD STE A
ORLANDO FL
32814-6652
US

V. Phone/Fax

Practice location:
  • Phone: 407-898-6588
  • Fax: 407-896-3785
Mailing address:
  • Phone: 407-898-6588
  • Fax: 407-896-3785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number9291823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: