Healthcare Provider Details

I. General information

NPI: 1003189432
Provider Name (Legal Business Name): CHILDREN'S MEDICAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 NW 183RD ST STE 133
MIAMI FL
33169-4531
US

IV. Provider business mailing address

99 NW 183RD ST STE 133
MIAMI FL
33169-4531
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-9979
  • Fax:
Mailing address:
  • Phone: 305-651-9979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0073654
License Number StateFL

VIII. Authorized Official

Name: ZAFAR I QURESHI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-651-9979