Healthcare Provider Details

I. General information

NPI: 1760960819
Provider Name (Legal Business Name): HAPPY KIDS PEDIATRIC CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 03/30/2024
Certification Date: 03/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5640 W ATLANTIC BLVD
MARGATE FL
33063-4523
US

IV. Provider business mailing address

1228 GOLDEN CANE DR
WESTON FL
33327-2423
US

V. Phone/Fax

Practice location:
  • Phone: 954-657-8060
  • Fax: 866-525-2237
Mailing address:
  • Phone: 787-431-0919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number116888
License Number StateFL

VIII. Authorized Official

Name: DR. CARMEN RAFAELA MEJIA-CARVAJAL
Title or Position: PEDIATRICIAN
Credential: MD
Phone: 954-716-9728