Healthcare Provider Details

I. General information

NPI: 1225598626
Provider Name (Legal Business Name): KIDZ MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE STE 125
MIAMI FL
33155-3009
US

IV. Provider business mailing address

5955 PONDE DE LEAON BLVD. C/O V CHEN,
CORAL GABLES FL
33146
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-1515
  • Fax: 833-464-4208
Mailing address:
  • Phone: 305-661-1515
  • Fax: 305-662-3723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. VINCENT CHEN
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 305-661-1515