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	ME68714	FL

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	:	1942582812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC PEDIATRIC PARTNERS LLC

Provider Business Mailing Address
First Line	:	7800 SW 87TH AVE
Second Line	:	SUITE C-350
City	:	MIAMI
State	:	FL
Zip	:	33173-2539
Country	:	US
Telephone Number	:	954-731-9676
Fax Number	:	954-731-9747

Provider Business Practice Location Address
First Line	:	14400 NW 77TH CT
Second Line	:	SUITE 102
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1590
Country	:	US
Telephone Number	:	305-823-7768
Fax Number	:	305-823-2211

Authorized Official
Title or Position	:	CEO
Name	:	PAUL J. GOLDBERG
Credential	:	M.D.
Telephone Number	:	954-435-7400

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	01/16/2020

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Directions to “ATLANTIC PEDIATRIC PARTNERS LLC ” Practice Location

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