=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134550890
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SANDRA ANN LOBAINA LM,CPM,IBCLC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2013
-----------------------------------------------------
Last Update Date | 05/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2750 N 29TH AVE STE 309
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33020-1521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-880-1182
-----------------------------------------------------
Fax | 954-301-8385
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 320 SW 67TH TER
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023-1274
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-600-8109
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | MW325
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 174N00000X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Non-RN)
-----------------------------------------------------
License Number | 11119829
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------