Lake City Birth, LLC

Organization Active NPI Birthing Clinic/Center · O Brien, FL

NPI 1285040097 · NPPES record last updated Jul 1, 2014

Key facts

NPI
1285040097
Entity type
Organization (NPI type 2)
Primary specialty
Birthing Clinic/Center 261QB0400X
License
MW 294 (FL)
Legal business name
LAKE CITY BIRTH, LLC
Practice address
5113 256TH St
O Brien, FL 32071-4435
Phone
(386) 299-0698
Fax
(800) 853-5087
NPI assigned
Jul 1, 2014
Organization subpart
No

Authorized official

Name
Angela Fennell, LM, CPM NPI 1871993824
Title
Owner
Phone
(386) 288-0698

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Birthing Clinic/Center 261QB0400X MW 294 FL Yes

Addresses

Primary practice location

5113 256TH St
O Brien, FL 32071-4435

Mailing address

5113 256TH St
O Brien, FL 32071-4435
Phone (386) 299-0698

Other providers in O Brien, FL

All providers in O Brien, FL · Birthing Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.