Provider Demographics
NPI:1659136513
Name:BIRTH CENTER OF FLORIDA, LLC
Entity Type:Organization
Organization Name:BIRTH CENTER OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-290-0090
Mailing Address - Street 1:106 MYRTLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5632
Mailing Address - Country:US
Mailing Address - Phone:813-949-1185
Mailing Address - Fax:813-949-1162
Practice Address - Street 1:106 MYRTLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-5632
Practice Address - Country:US
Practice Address - Phone:813-949-1185
Practice Address - Fax:813-949-1162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing