Healthcare Provider Details

I. General information

NPI: 1053350025
Provider Name (Legal Business Name): VARIETY CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

PO BOX 865095
ORLANDO FL
32886-5095
US

V. Phone/Fax

Practice location:
  • Phone: 305-666-6511
  • Fax: 305-740-5064
Mailing address:
  • Phone: 786-624-5876
  • Fax: 786-624-2688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA FRANCE
Title or Position: ADMINISTRATIVE DIRECTOR, RCM
Credential:
Phone: 786-624-5876