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General NPI Number Information
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NPI Number | 1437245529
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Entity Type | Organization
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Legal Business Name | CHILDRENS DIAGNOSTIC & TREATMENT CENTER INC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 1401 S FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316
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Country | US
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Telephone | 954-728-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 1608 SE 3RD AVE FL 3
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2564
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Country | US
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Telephone | 954-728-8080
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Fax | 954-779-1957
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANA CALDERON RANDAZZO
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Credential | PHD
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Telephone | 954-728-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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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 | 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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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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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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