Provider Demographics
NPI:1144657834
Name:BAREFOOT BIRTH
Entity type:Organization
Organization Name:BAREFOOT BIRTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM, CLC
Authorized Official - Phone:813-944-9120
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:SYDNEY
Mailing Address - State:FL
Mailing Address - Zip Code:33587-0265
Mailing Address - Country:US
Mailing Address - Phone:813-944-9120
Mailing Address - Fax:
Practice Address - Street 1:1319 SYDNEY WASHER RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:FL
Practice Address - Zip Code:33527
Practice Address - Country:US
Practice Address - Phone:813-944-9120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW276176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty