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General NPI Number Information
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NPI Number | 1174200133
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Entity Type | Organization
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Legal Business Name | MOTHERLAND BIRTHING AND WELLNESS LLC
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 2207 VIA CORTONA ST
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City | PLANT CITY
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State | FL
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Zip | 33566-1026
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Country | US
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Telephone | 813-365-9454
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Fax | 813-798-6422
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Provider Business Mailing Address
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Address Line | 2501 WALDEN WOODS DR # 3491
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City | PLANT CITY
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State | FL
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Zip | 33566-7168
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Country | US
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Telephone | 813-365-9454
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Fax | 813-798-6422
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Authorized Official
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Title or Position | OWNER
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Name | TRIANA MONEZ BOGGS
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Credential | APRN, CNM
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Telephone | 813-365-9454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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