Provider Demographics
NPI:1477288132
Name:FULL CIRCLE MIDWIFERY
Entity type:Organization
Organization Name:FULL CIRCLE MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTEE
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:ZOSMAN CUPO
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:386-523-4412
Mailing Address - Street 1:403 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-3715
Mailing Address - Country:US
Mailing Address - Phone:386-523-4412
Mailing Address - Fax:386-269-9921
Practice Address - Street 1:125 W PLYMOUTH AVE STE B
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-2745
Practice Address - Country:US
Practice Address - Phone:386-259-8223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty