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General NPI Number Information
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NPI Number | 1205648102
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Entity Type | Organization
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Legal Business Name | NICKLAUS CHILDREN'S HOSPITAL
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 3601 NW 107TH AVE FL 3
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City | DORAL
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State | FL
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Zip | 33178-4377
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Country | US
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Telephone | 305-418-7771
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 NW 107TH AVE FL 3
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City | DORAL
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State | FL
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Zip | 33178-4377
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Country | US
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Telephone | 305-418-7771
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Fax |
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Authorized Official
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Title or Position | POSTDOCTORAL PROGRAM DIRECTOR
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Name | OSCAR AREVALO
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Credential |
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Telephone | 305-418-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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