Healthcare Provider Details

I. General information

NPI: 1497451983
Provider Name (Legal Business Name): PEDIATRIC DREAM CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3199 LAKE WORTH RD
PALM SPRINGS FL
33461-3652
US

IV. Provider business mailing address

3199 LAKE WORTH RD STE B2
PALM SPRINGS FL
33461-3652
US

V. Phone/Fax

Practice location:
  • Phone: 561-621-1801
  • Fax: 561-331-4603
Mailing address:
  • Phone: 561-621-1801
  • Fax: 561-331-4603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MYLAI GAROFALO
Title or Position: CEO
Credential: MD, FAAP
Phone: 239-410-1120