Healthcare Provider Details

I. General information

NPI: 1821765058
Provider Name (Legal Business Name): KIDZCHOICE PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S MIAMI AVE STE 703
MIAMI FL
33133-4214
US

IV. Provider business mailing address

3661 S MIAMI AVE STE 703
MIAMI FL
33133-4214
US

V. Phone/Fax

Practice location:
  • Phone: 786-216-5236
  • Fax:
Mailing address:
  • Phone: 786-216-5236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. NATHALIE CASTELLANOS
Title or Position: OWNER
Credential:
Phone: 786-216-5236