Healthcare Provider Details

I. General information

NPI: 1326587734
Provider Name (Legal Business Name): KEYS PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3438 DUCK AVE
KEY WEST FL
33040-4427
US

IV. Provider business mailing address

1107 KEY PLZ #268
KEY WEST FL
33040-4077
US

V. Phone/Fax

Practice location:
  • Phone: 305-293-4233
  • Fax:
Mailing address:
  • Phone: 305-293-4233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME11534
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9469600
License Number StateFL

VIII. Authorized Official

Name: CHASETTI HIDALGO
Title or Position: MANAGER
Credential:
Phone: 954-740-4406