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General NPI Number Information
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NPI Number | 1326402363
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Entity Type | Organization
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Legal Business Name | VARIETY CHILDREN'S HOSPITAL
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 10 SE CENTRAL PKWY SUITE 222
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City | STUART
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State | FL
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Zip | 34994-5913
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Country | US
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Telephone | 561-741-5628
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Fax | 772-266-8802
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Provider Business Mailing Address
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Address Line | PO BOX 863286
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City | ORLANDO
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State | FL
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Zip | 32886-3286
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SVP AND CFO
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Name | TIMOTHY BIRKENSTOCK
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Credential |
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Telephone | 786-624-6422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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