Healthcare Provider Details

I. General information

NPI: 1396280582
Provider Name (Legal Business Name): SUNWEST PEDIATRICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2016
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17150 ROYAL PALM BLVD #3
WESTON FL
33326-2333
US

IV. Provider business mailing address

17150 ROYAL PALM BLVD #3
WESTON FL
33326-2333
US

V. Phone/Fax

Practice location:
  • Phone: 954-349-9920
  • Fax:
Mailing address:
  • Phone: 954-349-9920
  • 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: DR. MARIBEL RIVERA-OCASIO
Title or Position: OWNER
Credential: M.D.
Phone: 954-349-9920