Provider Demographics
NPI:1851942825
Name:CHILDRENS PEDIATRICIANS GROUP
Entity Type:Organization
Organization Name:CHILDRENS PEDIATRICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIADNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAGUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-743-2996
Mailing Address - Street 1:10051 PINES BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6187
Mailing Address - Country:US
Mailing Address - Phone:954-743-2996
Mailing Address - Fax:954-589-2131
Practice Address - Street 1:10051 PINES BLVD STE A
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6187
Practice Address - Country:US
Practice Address - Phone:954-789-2996
Practice Address - Fax:954-589-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-21
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty