Provider Demographics
NPI: | 1952792806 |
---|---|
Name: | REIMON PEDIATRICS PA |
Entity Type: | Organization |
Organization Name: | REIMON PEDIATRICS PA |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/DOCTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | PEDRO |
Authorized Official - Middle Name: | CARLOS |
Authorized Official - Last Name: | REIMON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 305-220-1310 |
Mailing Address - Street 1: | 13155 SW 42ND ST |
Mailing Address - Street 2: | SUITE 106 |
Mailing Address - City: | MIAMI |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33175-3428 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 305-220-1310 |
Mailing Address - Fax: | 305-220-1323 |
Practice Address - Street 1: | 13155 SW 42ND ST |
Practice Address - Street 2: | SUITE 106 |
Practice Address - City: | MIAMI |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33175-3428 |
Practice Address - Country: | US |
Practice Address - Phone: | 305-220-1310 |
Practice Address - Fax: | 305-220-1323 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-02-13 |
Last Update Date: | 2015-02-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ME58770 | 261QP2300X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |