Provider Demographics
NPI:1659007086
Name:BELLY TO CRADLE, LLC
Entity Type:Organization
Organization Name:BELLY TO CRADLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:850-324-5393
Mailing Address - Street 1:5653 TIGER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-7774
Mailing Address - Country:US
Mailing Address - Phone:850-861-1422
Mailing Address - Fax:
Practice Address - Street 1:600 UNIVERSITY OFFICE BLVD BLDG 4
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6475
Practice Address - Country:US
Practice Address - Phone:850-324-5393
Practice Address - Fax:850-806-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty