Provider Demographics
NPI:1467802074
Name:SK PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:SK PEDIATRICS, PLLC
Other - Org Name:SUPERKIDS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LIZAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA CANDELARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-619-2460
Mailing Address - Street 1:9121 N MILITARY TRL
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5984
Mailing Address - Country:US
Mailing Address - Phone:561-619-2460
Mailing Address - Fax:561-828-9311
Practice Address - Street 1:9121 N MILITARY TRL
Practice Address - Street 2:SUITE 102
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5984
Practice Address - Country:US
Practice Address - Phone:561-619-2460
Practice Address - Fax:561-828-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty