# BABA HEALTHCARE

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

## Provider details

- **NPI number:** 1609268614
- **Authorized official:** MRS. DIANE CAROL ROBERSON (INSURANCE CREDENTAILING)
- **Authorized official phone:** (321) 956-7370

## Contact information

- **Practice address:** 948 S WICKHAM RD, STE, W MELBOURNE, FL 32904-1647
- **Practice address phone:** (321) 956-7370
- **Practice address fax:** (321) 956-7873
- **Mailing address:** 948 S WICKHAM RD, STE 103, W MELBOURNE, FL 32904-1647
- **Mailing address phone:** (321) 956-7370
- **Mailing address fax:** (321) 956-7873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | ARNP 9179052 | FL | Yes |

## Other

- **Enumeration date:** 02/27/2015
- **Last updated:** 02/27/2015