Healthcare Provider Details

I. General information

NPI: 1265901623
Provider Name (Legal Business Name): BLISS BIRTH AND WELLNESS CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 12/09/2019
Certification Date: 12/09/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2717 POINSETTIA AVE
WEST PALM BEACH FL
33407-5503
US

IV. Provider business mailing address

437 27TH ST
WEST PALM BEACH FL
33407-5419
US

V. Phone/Fax

Practice location:
  • Phone: 561-445-1253
  • Fax:
Mailing address:
  • Phone: 561-445-1253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: MS. MAYA GURUSWAMI
Title or Position: OWNER
Credential:
Phone: 561-445-1253