Provider Demographics
NPI:1265796957
Name:LAKELAND MIDWIFERY CARE INC.
Entity type:Organization
Organization Name:LAKELAND MIDWIFERY CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:POWER
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:863-660-0048
Mailing Address - Street 1:1923 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2655
Mailing Address - Country:US
Mailing Address - Phone:863-683-4663
Mailing Address - Fax:888-853-9293
Practice Address - Street 1:1923 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2655
Practice Address - Country:US
Practice Address - Phone:863-683-4663
Practice Address - Fax:888-853-9293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW175176B00000X
FLMW92176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340113800Medicaid
FL005568100Medicaid
FL340482000Medicaid