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General NPI Number Information
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NPI Number | 1336103837
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Entity Type | Organization
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Legal Business Name | EAST/WEST PEDIATRICS, P.A.
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 1319 SE 2ND AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-1809
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Country | US
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Telephone | 954-467-3053
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Fax | 954-467-5424
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Provider Business Mailing Address
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Address Line | 1319 SE 2ND AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-1809
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Country | US
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Telephone | 954-467-3053
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Fax | 954-467-5424
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. RAGINI DHARMAPPA
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Credential |
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Telephone | 954-452-7576
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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 | ME0037089
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME0037416
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License Number State | FL
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