Healthcare Provider Details
I. General information
NPI: 1902065634
Provider Name (Legal Business Name): NORTH MIAMI PEDIATRICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2008
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16401 NW 2ND AVE SUITE 202
MIAMI FL
33169-6036
US
IV. Provider business mailing address
16401 NW 2ND AVE SUITE 202
MIAMI FL
33169-6036
US
V. Phone/Fax
- Phone: 305-947-4734
- Fax: 305-944-0619
- Phone: 305-947-4734
- Fax: 305-944-0619
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SHARI
WILLIAMS
Title or Position: PHYSICIAN/NEW OWNER
Credential: MD
Phone: 305-947-4734