Provider Demographics
NPI:1609292861
Name:VAUGHN, MURAIHA ROSE (CPM, LM)
Entity Type:Individual
Prefix:
First Name:MURAIHA
Middle Name:ROSE
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2359 BURNS AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3151
Mailing Address - Country:US
Mailing Address - Phone:321-614-2354
Mailing Address - Fax:321-724-6347
Practice Address - Street 1:209 CARTIER AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-7014
Practice Address - Country:US
Practice Address - Phone:321-614-2354
Practice Address - Fax:321-724-6347
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW275176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife