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General NPI Number Information
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NPI Number | 1164662748
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Entity Type | Organization
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Legal Business Name | MOBILE MIDWIFE, INC
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 12945 W DIXIE HWY
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4809
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Country | US
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Telephone | 786-975-9222
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Fax | 786-513-0380
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Provider Business Mailing Address
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Address Line | 930 NE 205TH ST
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City | MIAMI
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State | FL
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Zip | 33179-1918
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Country | US
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Telephone | 786-975-9222
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Fax | 786-513-0380
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Authorized Official
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Title or Position | LICENSED MIDWIFE
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Name | MRS. ADA REBECA SPROUSE
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Credential |
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Telephone | 786-975-9222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | MW208
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License Number State | FL
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