=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851162481
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE HOSPITAL DOULAS & ASSOCIATES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2024
-----------------------------------------------------
Last Update Date | 01/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 328 CLUB COVE DR
-----------------------------------------------------
City | TITUSVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32780-2314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-799-5104
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1969 S ALAFAYA TRL STE 108
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32828-8732
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-456-8455
-----------------------------------------------------
Fax | 407-442-0759
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-FOUNDER
-----------------------------------------------------
Name | MRS. LISA JEAN CIPRIANO COLLINS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-456-8455
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------