MEDICARE: DIANA JANOPAUL LM.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	MW191	FL

General Provider Information

NPI Number	:	1679639330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA JANOPAUL LM.

Provider Business Mailing Address
First Line	:	260 E 6TH AVE
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-6208
Country	:	US
Telephone Number	:	850-224-2229
Fax Number	:	850-681-6969

Provider Business Practice Location Address
First Line	:	260 E 6TH AVE
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-6208
Country	:	US
Telephone Number	:	850-224-2229
Fax Number	:	850-681-6969

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/08/2007

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