| Organization Name: | MIDDLEBROOK PEDIATRICS LLC |
| NPI Number: | 1285098137 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VERONICA OMENKA (PHYSICIAN) |
| Mailing Address: | 18528 Office Park Dr Montgomery Village |
| State: | MD US |
| Postal Code: | 208860586 |
| Phone Number: | 3013304130 |
| Fax Number: | 3013304150 |
| NPI Enumeration Date: | 04/07/2016 |
| NPI Last Update Date: | 04/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | D0065257 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |