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General NPI Number Information
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NPI Number | 1861003832
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Entity Type | Organization
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Legal Business Name | MJ LACTATION SERVICES
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 363 ARAGON AVE APT 611W
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City | CORAL GABLES
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State | FL
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Zip | 33134-5072
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Country | US
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Telephone | 786-427-4426
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Fax |
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Provider Business Mailing Address
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Address Line | 363 ARAGON AVE APT 611W
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City | CORAL GABLES
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State | FL
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Zip | 33134-5072
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Country | US
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Telephone | 786-427-4426
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Fax |
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Authorized Official
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Title or Position | LACTATION CONSULTANT
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Name | FATIMA GONZALEZ
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Credential | IBCLC
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Telephone | 786-427-4426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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