Provider Demographics
NPI:1528628831
Name:FULL CIRCLE BIRTH CENTER
Entity type:Organization
Organization Name:FULL CIRCLE BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:ALARICE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-674-0022
Mailing Address - Street 1:6871 BELFORT OAKS PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6242
Mailing Address - Country:US
Mailing Address - Phone:904-674-0022
Mailing Address - Fax:904-425-0192
Practice Address - Street 1:6885 BELFORT OAKS PL STE 215
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6234
Practice Address - Country:US
Practice Address - Phone:904-674-0022
Practice Address - Fax:904-425-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing