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Contact Information

PEDIATRIC &ADOLESCENT MEDICINE
7150 W 20TH AVE STE 612
HIALEAH, FL33016-5534
 Phone: 305-827-1561
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC ADOLESCENT MEDICINE · (Female)

NPI # 1154712198
Status Active
Credentials
Entity Individual
Enumeration date 02/12/2015
Last updated 02/12/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ME0063187
  • FL Medicaid 372063200
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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