Provider Demographics
NPI:1144389628
Name:TREASURE COAST PEDIATRIC ASSOCIATES,P.A.
Entity Type:Organization
Organization Name:TREASURE COAST PEDIATRIC ASSOCIATES,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRINIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-283-0278
Mailing Address - Street 1:506 SW FEDERAL HWY
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2827
Mailing Address - Country:US
Mailing Address - Phone:772-283-0278
Mailing Address - Fax:772-220-6626
Practice Address - Street 1:506 SW FEDERAL HWY
Practice Address - Street 2:SUITE # 101
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2827
Practice Address - Country:US
Practice Address - Phone:772-283-0278
Practice Address - Fax:772-220-6626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 396312080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty