Healthcare Provider Details

I. General information

NPI: 1790474971
Provider Name (Legal Business Name): TAMPA BAY MIDWIVES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8326 PINE RIVER RD
TAMPA FL
33637-1011
US

IV. Provider business mailing address

8326 PINE RIVER RD
TAMPA FL
33637-1011
US

V. Phone/Fax

Practice location:
  • Phone: 813-461-3844
  • Fax:
Mailing address:
  • Phone: 813-461-3844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE MARIE RUFFALO
Title or Position: CO-PRESIDENT
Credential: LM
Phone: 321-223-6707