Provider Demographics
NPI:1760960819
Name:HAPPY KIDS PEDIATRIC CLINIC PA
Entity Type:Organization
Organization Name:HAPPY KIDS PEDIATRIC CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:RAFAELA
Authorized Official - Last Name:MEJIA-CARVAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-716-9728
Mailing Address - Street 1:1228 GOLDEN CANE DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2423
Mailing Address - Country:US
Mailing Address - Phone:787-431-0919
Mailing Address - Fax:
Practice Address - Street 1:5640 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-4523
Practice Address - Country:US
Practice Address - Phone:954-657-8060
Practice Address - Fax:866-525-2237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL116888208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty