MEDICARE: ATLANTIC PEDIATRIC PARTNERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295383420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC PEDIATRIC PARTNERS LLC

Provider Business Mailing Address
First Line	:	7800 SW 87TH AVE STE C350
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3570
Country	:	US
Telephone Number	:	954-731-9676
Fax Number	:	954-731-9747

Provider Business Practice Location Address
First Line	:	5901 SW 74TH ST STE 308
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5163
Country	:	US
Telephone Number	:	305-665-5808
Fax Number	:	305-665-6761

Authorized Official
Title or Position	:	CFO
Name	:	MANNY ZAMORA
Credential	:
Telephone Number	:	954-731-9676

Provider Enumeration Date	:	08/30/2019
Last Update Date	:	01/16/2020

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