Provider Demographics
NPI:1407592231
Name:TEAMWORK BIRTHING
Entity Type:Organization
Organization Name:TEAMWORK BIRTHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARGAESPADA
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:407-506-6978
Mailing Address - Street 1:3814 WINGED FOOT CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-3040
Mailing Address - Country:US
Mailing Address - Phone:407-506-6978
Mailing Address - Fax:
Practice Address - Street 1:5104 N ORANGE BLOSSOM TRL STE 109
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-1013
Practice Address - Country:US
Practice Address - Phone:321-296-9399
Practice Address - Fax:407-650-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-05
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1659855682OtherMIDWIFE
FL1285902478OtherMIDWIFE