Healthcare Provider Details

I. General information

NPI: 1366632945
Provider Name (Legal Business Name): WORLD WIDE PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NW 70TH AVE SUITE # 107
PLANTATION FL
33317-2384
US

IV. Provider business mailing address

347 E GARDEN COVE CIR
DAVIE FL
33325-6709
US

V. Phone/Fax

Practice location:
  • Phone: 954-581-3100
  • Fax: 954-581-7773
Mailing address:
  • Phone: 305-975-5442
  • Fax: 954-474-9661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 95037
License Number StateFL

VIII. Authorized Official

Name: DR. JUAN CARLOS MILLON
Title or Position: OWNER
Credential: M.D.
Phone: 305-975-5442