# STORK SQUAD LLC

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

## Provider details

- **NPI number:** 1891450144
- **Authorized official:** KIMBERLY A VERBARG LM (DIRECTOR)
- **Authorized official phone:** (813) 685-8404

## Contact information

- **Practice address:** 215 LITHIA PINECREST RD, BRANDON, FL 33511-5307
- **Practice address phone:** (813) 685-8404
- **Practice address fax:** (813) 298-0620
- **Mailing address:** 215 LITHIA PINECREST RD, BRANDON, FL 33511-5307
- **Mailing address phone:** (813) 685-8404
- **Mailing address fax:** (813) 298-0620

## Taxonomy

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

## Other

- **Enumeration date:** 11/02/2021
- **Last updated:** 11/02/2021