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Organization

BIRTH AND BEYOND

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANITA LENAS (DIRECTOR)
(386) 659-2104
Entity
Organization

Contact information

Practice address
479 HOUSTON ST, GREEN COVE SPRINGS, FL 32043-2411
(904) 531-9504
(904) 531-9507
Mailing address
PO BOX 380129, GRANDIN, FL 32138-0129

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
660121902
FL
Enumeration date
08/02/2011
Last updated
08/02/2011
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