Healthcare Provider Details

I. General information

NPI: 1598801847
Provider Name (Legal Business Name): VARIETY CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE MCH LIFEFLIGHT-MARIA FERNANDEZ
MIAMI FL
33155-3009
US

IV. Provider business mailing address

3100 SW 62ND AVE MCH LIFEFLIGHT-MARIA FERNANDEZ
MIAMI FL
33155-3009
US

V. Phone/Fax

Practice location:
  • Phone: 305-663-8533
  • Fax: 305-669-6519
Mailing address:
  • Phone: 305-663-8533
  • Fax: 305-669-6519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number0435
License Number StateFL

VIII. Authorized Official

Name: PEDRO ALFARO
Title or Position: SENIOR VICE PRESIDENT CFO
Credential:
Phone: 305-666-6511