Healthcare Provider Details

I. General information

NPI: 1376060822
Provider Name (Legal Business Name): PEDIPEC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 ROYAL PALM BEACH BLVD STE 600
ROYAL PALM BEACH FL
33411-1695
US

IV. Provider business mailing address

1450 NW 159TH ST
MIAMI FL
33169-5727
US

V. Phone/Fax

Practice location:
  • Phone: 305-948-5683
  • Fax:
Mailing address:
  • Phone: 786-566-3562
  • Fax: 305-623-1012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DANIEL MILLER
Title or Position: VP
Credential:
Phone: 786-566-3562