Provider Demographics
NPI:1275712242
Name:MILTON MEMORIAL BIRTHING CENTER
Entity Type:Organization
Organization Name:MILTON MEMORIAL BIRTHING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/LM
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:MILTON
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:850-834-2946
Mailing Address - Street 1:952 FLOWERSVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUREL HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32567-3543
Mailing Address - Country:US
Mailing Address - Phone:850-834-2946
Mailing Address - Fax:850-834-3138
Practice Address - Street 1:952 FLOWERSVIEW BLVD
Practice Address - Street 2:
Practice Address - City:LAUREL HILL
Practice Address - State:FL
Practice Address - Zip Code:32567-3543
Practice Address - Country:US
Practice Address - Phone:850-834-2946
Practice Address - Fax:850-834-3138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL278251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management