Provider Demographics
NPI:1669846390
Name:CIMA PEDIATRICS CV, LLC
Entity Type:Organization
Organization Name:CIMA PEDIATRICS CV, LLC
Other - Org Name:CIMA KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCELA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-250-4447
Mailing Address - Street 1:1841 CHAMBLEE TUCKER RD
Mailing Address - Street 2:SUITE 1-7B
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-2754
Mailing Address - Country:US
Mailing Address - Phone:678-894-4147
Mailing Address - Fax:678-215-2047
Practice Address - Street 1:1841 CHAMBLEE TUCKER RD
Practice Address - Street 2:SUITE 1-7B
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-2754
Practice Address - Country:US
Practice Address - Phone:678-894-4147
Practice Address - Fax:678-722-8329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA208000000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty