Healthcare Provider Details
I. General information
NPI: 1346347051
Provider Name (Legal Business Name): PEDIATRIX MEDICAL GROUP OF KANSAS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/17/2006
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
550 N HILLSIDE AVE
WICHITA KS
67214-4910
US
IV. Provider business mailing address
1301 CONCORD TER
SUNRISE FL
33323-2843
US
V. Phone/Fax
- Phone: 316-962-8550
- Fax: 316-962-8581
- Phone: 954-384-0175
- Fax: 954-851-1948
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARIA
BAUTISTA-NAVARRO
Title or Position: PRESIDENT
Credential: MD
Phone: 800-243-3839