Provider Demographics
NPI:1891423976
Name:COOL KIDZ PEDIATRICS LLC
Entity Type:Organization
Organization Name:COOL KIDZ PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KESHAVA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-655-5807
Mailing Address - Street 1:208 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-3602
Mailing Address - Country:US
Mailing Address - Phone:813-873-1725
Mailing Address - Fax:
Practice Address - Street 1:301 N PARSONS AVE STE A
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-4517
Practice Address - Country:US
Practice Address - Phone:813-655-5807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOL KIDZ PEDIATRICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty