Provider Demographics
NPI:1619173218
Name:PALMETTO BAY MATERNITY CENTER
Entity Type:Organization
Organization Name:PALMETTO BAY MATERNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:305-798-2884
Mailing Address - Street 1:9020 SW 186TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7965
Mailing Address - Country:US
Mailing Address - Phone:305-798-2884
Mailing Address - Fax:
Practice Address - Street 1:9020 SW 186TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-7965
Practice Address - Country:US
Practice Address - Phone:305-798-2884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW166176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty