Provider Demographics
NPI:1851453161
Name:HOLLYWOOD BIRTH CENTER
Entity Type:Organization
Organization Name:HOLLYWOOD BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT LICENSED MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:954-925-4499
Mailing Address - Street 1:2316 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6703
Mailing Address - Country:US
Mailing Address - Phone:954-925-4499
Mailing Address - Fax:954-925-2756
Practice Address - Street 1:2316 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6703
Practice Address - Country:US
Practice Address - Phone:954-925-4499
Practice Address - Fax:954-925-2756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22953OtherNEIGHBORHOOD HEALTH PLAN
FL293433OtherAMERIGROUP
FL690006200Medicaid
FLB0109OtherBLUE CROSS BLUE SHIELD
FL237106OtherAVMED
FLN170517OtherSTAYWELL
FL5123292OtherAETNA