Healthcare Provider Details

I. General information

NPI: 1013116292
Provider Name (Legal Business Name): KID CARE PEDIATRICS, P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801A W 48TH ST
HIALEAH FL
33012-3541
US

IV. Provider business mailing address

801A W 48TH ST
HIALEAH FL
33012-3541
US

V. Phone/Fax

Practice location:
  • Phone: 305-821-1600
  • Fax: 305-821-1632
Mailing address:
  • Phone: 305-821-1600
  • Fax: 305-821-1632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MARIA VICTORIA FERNANDEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 305-821-1600