Provider Demographics
NPI:1952458085
Name:PEDIATRIC CONSULTANTS OF KENDALL, P.A.
Entity Type:Organization
Organization Name:PEDIATRIC CONSULTANTS OF KENDALL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-223-3131
Mailing Address - Street 1:PO BOX 652638
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33265-2638
Mailing Address - Country:US
Mailing Address - Phone:305-223-3131
Mailing Address - Fax:305-553-3888
Practice Address - Street 1:11880 SW 40TH ST
Practice Address - Street 2:SUITE # 305
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3584
Practice Address - Country:US
Practice Address - Phone:305-223-3131
Practice Address - Fax:305-553-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty