Provider Demographics
NPI:1811234602
Name:CELEBRATE BIRTH MIDWIFERY, INC
Entity Type:Organization
Organization Name:CELEBRATE BIRTH MIDWIFERY, INC
Other - Org Name:CELEBRATE BIRTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-602-1422
Mailing Address - Street 1:1525 EDGEWATER BEACH DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4737
Mailing Address - Country:US
Mailing Address - Phone:863-680-2229
Mailing Address - Fax:863-682-4784
Practice Address - Street 1:1525 EDGEWATER BEACH DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4737
Practice Address - Country:US
Practice Address - Phone:863-680-2229
Practice Address - Fax:863-682-4784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW175176B00000X
FL268261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340482000Medicaid