Provider Demographics
NPI:1790975118
Name:MIRACLES MATERNITY MANAGEMENT OF FLORIDA
Entity Type:Organization
Organization Name:MIRACLES MATERNITY MANAGEMENT OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:I
Authorized Official - Last Name:ARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-376-3790
Mailing Address - Street 1:PO BOX 8809
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33674
Mailing Address - Country:US
Mailing Address - Phone:813-376-3790
Mailing Address - Fax:813-232-5904
Practice Address - Street 1:1913 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-376-3790
Practice Address - Fax:813-232-5904
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIRACLES MATERNITY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 56663207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty