Organization
SPIRIT OF LIFE TRADITIONAL MIDWIFERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHEILA SIMMS WATSON L.M. (PRESIDENT)
(786) 287-0484
Entity
Organization
Contact information
Practice address
17304 WALKER AVE, #116, MIAMI, FL 33157-4389
(786) 287-0484
(305) 235-6688
Mailing address
9745 SW 161ST ST, MIAMI, FL 33157-3315
(786) 287-0484
(305) 235-6688
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MW 141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340228200
—
FL
01
—
N205340
HEALTHEASE PROVIDER #
FL
01
—
Y005R
BLUE CROSS PROVIDER #
FL
Enumeration date
04/13/2007
Last updated
12/02/2013
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