Provider Demographics
NPI:1619001674
Name:CROSSINGS PEDIATRICS
Entity Type:Organization
Organization Name:CROSSINGS PEDIATRICS
Other - Org Name:CROSSINGS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTEBAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GENAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-387-2060
Mailing Address - Street 1:13059 SW 112TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4601
Mailing Address - Country:US
Mailing Address - Phone:305-387-2060
Mailing Address - Fax:305-387-2044
Practice Address - Street 1:13059 SW 112TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4601
Practice Address - Country:US
Practice Address - Phone:305-387-2060
Practice Address - Fax:305-387-2044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58604261Q00000X
FLME57254261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC37721Medicare UPIN
FLE19766Medicare UPIN
FL14671Medicare ID - Type UnspecifiedESTEBAN GENAO
FL23913Medicare ID - Type UnspecifiedISABEL FERREIRA