Provider Demographics
NPI:1851408256
Name:SOUTH FLORIDA PEDIATRICS INC
Entity Type:Organization
Organization Name:SOUTH FLORIDA PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SOUTH FLORIDA PEDIATRICS
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:URIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-821-3388
Mailing Address - Street 1:5590 W 20TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-7061
Mailing Address - Country:US
Mailing Address - Phone:305-821-3388
Mailing Address - Fax:305-821-3116
Practice Address - Street 1:5590 W 20TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-7061
Practice Address - Country:US
Practice Address - Phone:305-821-3388
Practice Address - Fax:305-821-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55642208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E75869Medicare UPIN