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General NPI Number Information
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NPI Number | 1538367297
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Entity Type | Individual
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Provider Name | MARTHA ANGELICA PEROLDO CNM ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/04/2007
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 9333 SW 152ND ST
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City | VILLAGE OF PALMETTO BAY
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State | FL
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Zip | 33157-1778
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Country | US
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Telephone | 305-256-2326
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Fax |
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Provider Business Mailing Address
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Address Line | 8250 SW 130TH ST
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City | PINECREST
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State | FL
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Zip | 33156-6663
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Country | US
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Telephone | 305-234-0257
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2219652
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License Number State | FL
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