Provider Demographics
NPI:1962894303
Name:CELESTIAL MIDWIFERY, INC.
Entity type:Organization
Organization Name:CELESTIAL MIDWIFERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:407-923-6874
Mailing Address - Street 1:1308 OLYMPIA PARK CIR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-2427
Mailing Address - Country:US
Mailing Address - Phone:407-923-6874
Mailing Address - Fax:407-614-3658
Practice Address - Street 1:1308 OLYMPIA PARK CIR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2427
Practice Address - Country:US
Practice Address - Phone:407-923-6874
Practice Address - Fax:407-614-3658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW279176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010362800Medicaid