Organization Name: | PEDIATRICS PA |
NPI Number: | 1053472019 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RUFUS JOSEPH (PRESIDENT) |
Mailing Address: | 3220 S Douglas Rd Ste B Miramar |
State: | FL US |
Postal Code: | 330252734 |
Phone Number: | 9544368444 |
Fax Number: | 9544361159 |
NPI Enumeration Date: | 12/13/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | ME52086 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |