Provider Demographics
NPI:1669710455
Name:BIRTH CENTER OF JACKSONVILLE
Entity type:Organization
Organization Name:BIRTH CENTER OF JACKSONVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-633-3333
Mailing Address - Street 1:804 MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-3224
Mailing Address - Country:US
Mailing Address - Phone:904-633-3333
Mailing Address - Fax:904-339-9011
Practice Address - Street 1:804 MARGARET ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-3224
Practice Address - Country:US
Practice Address - Phone:904-633-3333
Practice Address - Fax:904-339-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing