=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861419657
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE FRANCES GANDY CNM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5449 S SEMORAN BLVD SUITE 14D
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32822-1722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-207-7757
-----------------------------------------------------
Fax | 407-249-4781
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13961 MYRTLEWOOD DR
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32832-5714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-380-8704
-----------------------------------------------------
Fax | 407-380-8704
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number | ARNP0951432
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------