Provider Demographics
NPI:1972195493
Name:WONDERKIDZ PEDIATRICS LLC
Entity Type:Organization
Organization Name:WONDERKIDZ PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING MEMBER AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VIOLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTACHARYYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-799-4086
Mailing Address - Street 1:151 N NOB HILL RD STE 340
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1708
Mailing Address - Country:US
Mailing Address - Phone:954-799-4086
Mailing Address - Fax:954-405-8594
Practice Address - Street 1:5700 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6350
Practice Address - Country:US
Practice Address - Phone:954-799-4086
Practice Address - Fax:954-405-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty