Provider Demographics
NPI: | 1760088967 |
---|---|
Name: | KIDZ MEDICAL SERVICES |
Entity Type: | Organization |
Organization Name: | KIDZ MEDICAL SERVICES |
Other - Org Name: | PEDIATRIC PULMONOLOGY GROUP OF SOUTH FLORIDA |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | IRENE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NAVARRO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 305-661-1515 |
Mailing Address - Street 1: | 5955 PONCE DE LEON BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | CORAL GABLES |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33146-2423 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 305-661-1515 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3200 SW 60TH CT STE 203 |
Practice Address - Street 2: | |
Practice Address - City: | MIAMI |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33155-4070 |
Practice Address - Country: | US |
Practice Address - Phone: | 305-662-8380 |
Practice Address - Fax: | 866-832-5324 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-12-11 |
Last Update Date: | 2023-07-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2080P0214X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology | Group - Single Specialty |