Provider Demographics
NPI:1104965854
Name:MATERNAL CHILD HEALTH COALITION
Entity type:Organization
Organization Name:MATERNAL CHILD HEALTH COALITION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUERVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-281-5535
Mailing Address - Street 1:3825 HENDERSON BLVD STE 505
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5031
Mailing Address - Country:US
Mailing Address - Phone:813-281-5535
Mailing Address - Fax:813-281-5538
Practice Address - Street 1:3825 HENDERSON BLVD STE 505
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5031
Practice Address - Country:US
Practice Address - Phone:813-281-5535
Practice Address - Fax:813-281-5538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable