Provider Demographics
NPI:1508698382
Name:EXCEPTIONAL MEMORIES MATERNITY CARE
Entity type:Organization
Organization Name:EXCEPTIONAL MEMORIES MATERNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEDEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-227-1523
Mailing Address - Street 1:140 NE 119TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5375
Mailing Address - Country:US
Mailing Address - Phone:305-754-2229
Mailing Address - Fax:305-754-2195
Practice Address - Street 1:140 NE 119TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5375
Practice Address - Country:US
Practice Address - Phone:305-754-2229
Practice Address - Fax:305-754-2195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty