Healthcare Provider Details
I. General information
NPI: 1255332110
Provider Name (Legal Business Name): INFANTS AND CHILDREN, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2005
Last Update Date: 07/21/2022
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5205 VILLAGE BLVD
WEST PALM BEACH FL
33407-7907
US
IV. Provider business mailing address
1401 FORUM WAY SUITE 300
WPB FL
33401
US
V. Phone/Fax
- Phone: 561-242-0227
- Fax: 561-242-9883
- Phone: 561-242-0505
- Fax: 561-242-9548
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
RONALD
A
ROMEAR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-242-0505