Provider Demographics
NPI:1598201121
Name:MIZRACHI, NAOMI (LM, CPM)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:MIZRACHI
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 GAIL BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-4027
Mailing Address - Country:US
Mailing Address - Phone:239-777-4691
Mailing Address - Fax:
Practice Address - Street 1:4620 GAIL BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-4027
Practice Address - Country:US
Practice Address - Phone:239-777-4691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW341176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife