Healthcare Provider Details

I. General information

NPI: 1437377439
Provider Name (Legal Business Name): JJ PEDIATRICS, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21321 E. OCOTILLO RD #110
QUEEN CREEK AZ
85242-0000
US

IV. Provider business mailing address

21321 E OCOTILLO RD STE 110
QUEEN CREEK AZ
85242-5996
US

V. Phone/Fax

Practice location:
  • Phone: 480-677-4545
  • Fax: 480-677-4356
Mailing address:
  • Phone: 480-677-4545
  • Fax: 480-677-4356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36321
License Number StateAZ

VIII. Authorized Official

Name: DR. MILOSLAV HRKAL
Title or Position: OWNER
Credential: M.D.
Phone: 480-677-4545