MEDICARE: MS. SHEILA GIBSON CNM

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	367A00000X	Advanced Practice Midwife	ARNP1700452	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750383352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHEILA GIBSON CNM

Provider Business Mailing Address
First Line	:	1600 S. ANDREWS AVENUE
Second Line	:	SUITE 323 WEST WING
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316
Country	:	US
Telephone Number	:	954-355-5110
Fax Number	:	954-355-4919

Provider Business Practice Location Address
First Line	:	200 NW 7TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-9026
Country	:	US
Telephone Number	:	954-355-5110
Fax Number	:	954-355-4919

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	07/11/2014

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