Provider Demographics
NPI:1417950684
Name:PEDIATRIC PROFESSIONAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:PEDIATRIC PROFESSIONAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMOVITCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-271-8222
Mailing Address - Street 1:7001 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2505
Mailing Address - Country:US
Mailing Address - Phone:305-271-8222
Mailing Address - Fax:305-274-6316
Practice Address - Street 1:7001 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2505
Practice Address - Country:US
Practice Address - Phone:305-271-8222
Practice Address - Fax:305-274-6316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0319624208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty