Healthcare Provider Details

I. General information

NPI: 1568239861
Provider Name (Legal Business Name): DEERFIELD BEACH PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 11/26/2024
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 SW NATURA AVE SUITE 102
DEERFIELD BEACH FL
33441
US

IV. Provider business mailing address

260 SW NATURA AVE SUITE 102
DEERFIELD BEACH FL
33441
US

V. Phone/Fax

Practice location:
  • Phone: 954-505-8524
  • Fax: 954-628-5866
Mailing address:
  • Phone: 954-505-8524
  • 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: SABINA THATCHER
Title or Position: CO-OWNER
Credential: ARNP, CPNP-PC
Phone: 954-505-8524