Healthcare Provider Details

I. General information

NPI: 1679437891
Provider Name (Legal Business Name): NATIVITY PEDIATRICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 GRIFFIN RD STE 311
DAVIE FL
33314-4416
US

IV. Provider business mailing address

861 NW 66TH AVE
PLANTATION FL
33317-1235
US

V. Phone/Fax

Practice location:
  • Phone: 954-737-6538
  • Fax:
Mailing address:
  • Phone: 954-737-6538
  • Fax: 954-824-8409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAOLA PARE
Title or Position: PEDIATRICIAN
Credential: DO
Phone: 954-737-6538