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General NPI Number Information
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NPI Number | 1902021322
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Entity Type | Organization
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Legal Business Name | SPIRIT OF LIFE TRADITIONAL MIDWIFERY
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 17304 WALKER AVE #116
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City | MIAMI
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State | FL
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Zip | 33157-4389
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Country | US
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Telephone | 786-287-0484
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Fax | 305-235-6688
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Provider Business Mailing Address
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Address Line | 9745 SW 161ST ST
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City | MIAMI
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State | FL
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Zip | 33157-3315
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Country | US
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Telephone | 786-287-0484
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Fax | 305-235-6688
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SHEILA SIMMS WATSON
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Credential | L.M.
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Telephone | 786-287-0484
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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 | MW 141
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License Number State | FL
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