Organization
ANCIENT CITY MIDWIVES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE ROGERO ARNP CNM (PRESIDENT)
(904) 826-1007
Entity
Organization
Contact information
Practice address
1301 PLANTATION ISLAND DR S, STE 105-B, ST AUGUSTINE, FL 32080-3108
(904) 826-1007
(904) 826-1073
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 824-4990
(904) 824-2226
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
ARNP 1634442
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000664500
—
FL
01
—
98118
BCBS
FL
Enumeration date
09/08/2008
Last updated
05/14/2012
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