# MODERN ORLANDO MIDWIFERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295398162
- **Authorized official:** LAURA GAYLE NATHAN LM CPM (OWNER)
- **Authorized official phone:** (407) 907-2601

## Contact information

- **Practice address:** 512 FERNWOOD DR, ALTAMONTE SPRINGS, FL 32701-6330
- **Practice address phone:** (407) 907-2601
- **Practice address fax:** (407) 289-4050
- **Mailing address:** 512 FERNWOOD DR, ALTAMONTE SPRINGS, FL 32701-6330
- **Mailing address phone:** (407) 907-2601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | — | NULL | Yes |
| 176B00000X | Midwife | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2019
- **Last updated:** 04/17/2019