Healthcare Provider Details

I. General information

NPI: 1487635447
Provider Name (Legal Business Name): CENTER FOR PEDIATRIC CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 SW 34TH ST
MIAMI FL
33165-3615
US

IV. Provider business mailing address

10710 SW 34TH ST
MIAMI FL
33165-3615
US

V. Phone/Fax

Practice location:
  • Phone: 305-559-3605
  • Fax: 305-559-7287
Mailing address:
  • Phone: 305-559-3605
  • Fax: 305-559-7287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LORETA BIDOT
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 305-559-3605