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General NPI Number Information
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NPI Number | 1336967090
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Entity Type | Organization
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Legal Business Name | GROWING TOGETHER PEDIATRIC MEDICAL PC
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 8714 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2036
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Country | US
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Telephone | 718-296-2020
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Fax | 718-296-1781
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Provider Business Mailing Address
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Address Line | 8714 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2036
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Country | US
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Telephone | 718-296-2020
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Fax | 718-296-1781
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Authorized Official
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Title or Position | OWNER
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Name | HECTOR BIENVENIDO FLORIMON DE LA ROSA
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Credential | MD
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Telephone | 718-296-2020
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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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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 |
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License Number State |
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