Healthcare Provider Details

I. General information

NPI: 1750035739
Provider Name (Legal Business Name): VERO BEACH PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2022
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 37TH PL
VERO BEACH FL
32960-6541
US

IV. Provider business mailing address

959 37TH PL
VERO BEACH FL
32960-6541
US

V. Phone/Fax

Practice location:
  • Phone: 772-226-6878
  • Fax:
Mailing address:
  • Phone: 772-226-6878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JESSICA CRUZ
Title or Position: PARTNER
Credential: MD
Phone: 772-569-3212