Provider Demographics
NPI:1942967278
Name:SOUTH FLORIDA MIDWIFERY SERVICES, LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA MIDWIFERY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:URDANETA AQUI
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:786-340-5895
Mailing Address - Street 1:3574 W 94TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2076
Mailing Address - Country:US
Mailing Address - Phone:786-340-5895
Mailing Address - Fax:
Practice Address - Street 1:10570 NW 27TH ST STE H102B
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2104
Practice Address - Country:US
Practice Address - Phone:786-280-8061
Practice Address - Fax:786-280-8061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service