Provider Demographics
NPI:1104397595
Name:MELLOW KIDS, PLLC.
Entity Type:Organization
Organization Name:MELLOW KIDS, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERSHON
Authorized Official - Middle Name:
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:786-521-1587
Mailing Address - Street 1:4350 POST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3012
Mailing Address - Country:US
Mailing Address - Phone:786-521-1587
Mailing Address - Fax:786-275-6916
Practice Address - Street 1:241 NE 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3805
Practice Address - Country:US
Practice Address - Phone:786-521-1587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric AnesthesiologyGroup - Single Specialty