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General NPI Number Information
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NPI Number | 1043391709
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Entity Type | Organization
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Legal Business Name | SMA PEDIATRICS, LLC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 38 DEAK DR
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City | SMYRNA
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State | DE
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Zip | 19977
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Country | US
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Telephone | 302-653-6174
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Fax | 302-653-6029
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Provider Business Mailing Address
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Address Line | 38 DEAK DR
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City | SMYRNA
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State | DE
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Zip | 19977
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Country | US
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Telephone | 302-653-6174
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Fax | 302-653-6029
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MA CARIDAD ROSAL
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Credential | MD
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Telephone | 302-653-6174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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