Provider Demographics
NPI:1558855205
Name:MOTHERS' MILK BANK OF FLORIDA
Entity Type:Organization
Organization Name:MOTHERS' MILK BANK OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KANDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NATOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-248-5050
Mailing Address - Street 1:8669 COMMODITY CIR STE 490
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-9003
Mailing Address - Country:US
Mailing Address - Phone:407-248-5050
Mailing Address - Fax:407-370-4340
Practice Address - Street 1:8669 COMMODITY CIR STE 490
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9003
Practice Address - Country:US
Practice Address - Phone:407-248-5050
Practice Address - Fax:407-370-4340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-17
Last Update Date:2018-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition