Provider Demographics
NPI:1538587332
Name:MIDWIFE360, LLC
Entity type:Organization
Organization Name:MIDWIFE360, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:FADWAH
Authorized Official - Last Name:HALABY
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:561-558-7198
Mailing Address - Street 1:3621 1/2 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-2227
Mailing Address - Country:US
Mailing Address - Phone:561-705-1022
Mailing Address - Fax:561-530-2066
Practice Address - Street 1:3621 1/2 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-2227
Practice Address - Country:US
Practice Address - Phone:561-705-1022
Practice Address - Fax:561-530-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9247125363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty