Healthcare Provider Details

I. General information

NPI: 1164091385
Provider Name (Legal Business Name): PEDIATRIX MEDICAL GROUP OF FLORIDA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 HAGEN RANCH RD STE 100B
BOYNTON BEACH FL
33437-3776
US

IV. Provider business mailing address

1301 CONCORD TER
SUNRISE FL
33323-2843
US

V. Phone/Fax

Practice location:
  • Phone: 954-983-1899
  • Fax: 855-527-5510
Mailing address:
  • Phone: 800-243-3839
  • Fax: 855-527-5510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA CHEN
Title or Position: PRESIDENT
Credential:
Phone: 800-243-3839