Provider Demographics
NPI:1073063210
Name:CARE FOR CHILDREN PEDIATRIC SERVICES, M.D.,P.A.
Entity Type:Organization
Organization Name:CARE FOR CHILDREN PEDIATRIC SERVICES, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:B
Authorized Official - Last Name:FERRETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-642-5990
Mailing Address - Street 1:3228 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4102
Mailing Address - Country:US
Mailing Address - Phone:305-642-5090
Mailing Address - Fax:305-642-9950
Practice Address - Street 1:3228 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4102
Practice Address - Country:US
Practice Address - Phone:305-642-5090
Practice Address - Fax:305-642-9950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002962201Medicaid