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General NPI Number Information
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NPI Number | 1144664442
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Entity Type | Organization
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Legal Business Name | HAPPY KIDZ PEDIATRICS, PL
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 4304 HIGHLAND PARK BLVD
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City | LAKELAND
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State | FL
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Zip | 33813-1647
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Country | US
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Telephone | 863-446-1583
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6039
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City | LAKELAND
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State | FL
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Zip | 33807-6039
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Country | US
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Telephone | 863-446-1583
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Fax |
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | DR. ANOOP KUMAR PALTA
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Credential | M.D.
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Telephone | 863-446-1583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME96413
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME98082
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License Number State | FL
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