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General NPI Number Information
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NPI Number | 1336517234
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Entity Type | Organization
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Legal Business Name | LABOR OF LOVE FAMILY BIRTH CENTER, LLC
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 990 BROADWAY SUITE C
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City | DUNEDIN
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State | FL
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Zip | 34698-5763
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Country | US
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Telephone | 727-734-2229
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Fax | 727-734-8855
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Provider Business Mailing Address
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Address Line | 990 BROADWAY SUITE C
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City | DUNEDIN
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State | FL
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Zip | 34698-5763
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Country | US
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Telephone | 727-734-2229
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Fax | 727-734-8855
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ROBYN MATTOX
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Credential | LM, CPM
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Telephone | 407-625-0482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number | 295
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License Number State | FL
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