Provider Demographics
NPI:1730724006
Name:BLESSINGS IN ABUNDANCE MIDWIFERY CARE PLLC
Entity type:Organization
Organization Name:BLESSINGS IN ABUNDANCE MIDWIFERY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SURPRENANT
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:407-466-5982
Mailing Address - Street 1:903 JAMELA DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-1905
Mailing Address - Country:US
Mailing Address - Phone:407-466-5982
Mailing Address - Fax:
Practice Address - Street 1:903 JAMELA DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-1905
Practice Address - Country:US
Practice Address - Phone:407-466-5982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL19000116347OtherBUSINESS LICENSE