Healthcare Provider Details

I. General information

NPI: 1861194698
Provider Name (Legal Business Name): CHEEMA PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39200 HOOKER HWY
BELLE GLADE FL
33430-5368
US

IV. Provider business mailing address

2326 S CONGRESS AVE STE 2D
WEST PALM BEACH FL
33406-7614
US

V. Phone/Fax

Practice location:
  • Phone: 561-996-6571
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIELA GHIRAGOSSIAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 561-268-6509