Provider Demographics
NPI:1437318367
Name:PEDIATRIC WIZARDS, PA
Entity Type:Organization
Organization Name:PEDIATRIC WIZARDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HELFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-255-3434
Mailing Address - Street 1:1310 W EAU GALLIE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5300
Mailing Address - Country:US
Mailing Address - Phone:321-255-3434
Mailing Address - Fax:321-255-0963
Practice Address - Street 1:1310 W EAU GALLIE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-5300
Practice Address - Country:US
Practice Address - Phone:321-255-3434
Practice Address - Fax:321-255-0963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82113208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty