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General NPI Number Information
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NPI Number | 1588360747
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Entity Type | Organization
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Legal Business Name | CLOVER LEAF MIDWIFERY, LLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 4020 BLUE LANTANA LN
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City | LAND O LAKES
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State | FL
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Zip | 34638-3561
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Country | US
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Telephone | 727-387-3939
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Fax | 813-536-3061
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Provider Business Mailing Address
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Address Line | 18865 STATE ROAD 54 STE 181
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City | LUTZ
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State | FL
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Zip | 33558-8201
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Country | US
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Telephone |
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Fax | 813-536-3061
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Authorized Official
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Title or Position | MIDWIFE, OWNER
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Name | ERICA LEA DIBARTOLO-BARCLAY
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Credential | LM, LMT
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Telephone | 352-218-9288
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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 |
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License Number State |
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