Provider Demographics
NPI:1003488412
Name:PEDIATRIC ENDOCRINE AND METABOLIC CENTER OF FLORIDA, PLLC
Entity Type:Organization
Organization Name:PEDIATRIC ENDOCRINE AND METABOLIC CENTER OF FLORIDA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MILADYS
Authorized Official - Middle Name:MIRIAM
Authorized Official - Last Name:PALAU COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-834-7362
Mailing Address - Street 1:9401 SW DISCOVERY WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2381
Mailing Address - Country:US
Mailing Address - Phone:772-834-7362
Mailing Address - Fax:772-618-2024
Practice Address - Street 1:9401 SW DISCOVERY WAY STE 102
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2381
Practice Address - Country:US
Practice Address - Phone:772-834-7362
Practice Address - Fax:772-618-2024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty