Healthcare Provider Details

I. General information

NPI: 1548715899
Provider Name (Legal Business Name): ATLANTIC PEDIATRIC PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15671 SW 88TH ST
MIAMI FL
33196-1103
US

IV. Provider business mailing address

7800 SW 87TH AVE SUITE C-350
MIAMI FL
33173-3570
US

V. Phone/Fax

Practice location:
  • Phone: 305-752-6465
  • Fax: 305-752-6467
Mailing address:
  • Phone: 954-731-9676
  • Fax: 954-731-9747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MANNY ZAMORA
Title or Position: CFO
Credential:
Phone: 954-731-9676