Healthcare Provider Details

I. General information

NPI: 1376676833
Provider Name (Legal Business Name): AVENTURA PEDIATRIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20750 W DIXIE HWY
AVENTURA FL
33180-1146
US

IV. Provider business mailing address

20750 W DIXIE HWY
AVENTURA FL
33180-1146
US

V. Phone/Fax

Practice location:
  • Phone: 305-932-5533
  • Fax: 305-932-7666
Mailing address:
  • Phone: 305-932-5533
  • Fax: 305-932-7666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME89184
License Number StateFL

VIII. Authorized Official

Name: DR. VIRGINIA LEAH GLASER-ECHARTE
Title or Position: PRESIDENT
Credential: MD
Phone: 305-932-5533