Provider Demographics
NPI:1295981884
Name:SPECIAL CARE PEDIATRICS CORP
Entity type:Organization
Organization Name:SPECIAL CARE PEDIATRICS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEDINA CAPOTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-275-6070
Mailing Address - Street 1:10240 SW 56TH ST
Mailing Address - Street 2:STE 102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7071
Mailing Address - Country:US
Mailing Address - Phone:305-275-6070
Mailing Address - Fax:
Practice Address - Street 1:10240 SW 56TH ST
Practice Address - Street 2:STE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7071
Practice Address - Country:US
Practice Address - Phone:305-275-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68713208D00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty