=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518193556
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BABY STEPS HEALTH INCORPORATED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2009
-----------------------------------------------------
Last Update Date | 01/13/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6610 EMBASSY BLVD SUITE A
-----------------------------------------------------
City | PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34668-4897
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-457-0101
-----------------------------------------------------
Fax | 727-848-1700
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7847 OREGOLD DR
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34654-6363
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-457-0101
-----------------------------------------------------
Fax | 727-848-2229
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/ EARLY INTERVENTIONIST
-----------------------------------------------------
Name | MRS. CARMELA MARIE JONES
-----------------------------------------------------
Credential | ARNP
-----------------------------------------------------
Telephone | 727-457-0101
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 9176361
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------