Healthcare Provider Details

I. General information

NPI: 1720176357
Provider Name (Legal Business Name): CHILDREN PLUS HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7599 S DIXIE HWY
WEST PALM BEACH FL
33405-4813
US

IV. Provider business mailing address

7599 S DIXIE HWY
WEST PALM BEACH FL
33405-4813
US

V. Phone/Fax

Practice location:
  • Phone: 561-585-6565
  • Fax: 561-585-5262
Mailing address:
  • Phone: 561-585-6565
  • Fax: 561-585-5262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SERGIO RODRIGUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 561-585-6565