MEDICARE: JENNIE JOSEPH FAMILY SERVICES INC.

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	261QB0400X	Birthing Clinic/Center	314	FL

General Provider Information

NPI Number	:	1710907548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIE JOSEPH FAMILY SERVICES INC.

Provider Business Mailing Address
First Line	:	1150 E PLANT ST
Second Line	:	SUITE F
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-2922
Country	:	US
Telephone Number	:	407-656-6938
Fax Number	:	407-656-9161

Provider Business Practice Location Address
First Line	:	1150 E PLANT ST
Second Line	:	SUITE F
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-2922
Country	:	US
Telephone Number	:	407-656-6938
Fax Number	:	407-656-9161

Authorized Official
Title or Position	:	CLINICAL DIRECTOR AND MIDWIFE
Name	:	MS. JENNIFER SUSAN JOSEPH
Credential	:	LM, CPM
Telephone Number	:	407-656-6938

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	08/22/2020

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