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General NPI Number Information
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NPI Number | 1407388549
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Entity Type | Organization
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Legal Business Name | B.O.R.N., INC.
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 1255 NORMANDY DR
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City | MIAMI BEACH
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State | FL
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Zip | 33141
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Country | US
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Telephone | 305-335-1181
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Fax |
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Provider Business Mailing Address
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Address Line | 500 S SHORE DR
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City | MIAMI BEACH
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State | FL
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Zip | 33141-2404
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Country | US
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Telephone | 305-335-1181
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Fax |
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Authorized Official
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Title or Position | MIDWIFE
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Name | DANA GORDON
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Credential | L.M., C.P.M.
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Telephone | 305-335-1181
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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 | MW215
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License Number State | FL
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