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General NPI Number Information
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NPI Number | 1558459206
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Entity Type | Organization
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Legal Business Name | METROPOLITAN PEDIATRIC SPECIALISTS, P.A.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 6517 DREW AVE S
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City | EDINA
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State | MN
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Zip | 55435-2103
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Country | US
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Telephone | 952-920-9191
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Fax | 952-920-0232
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Provider Business Mailing Address
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Address Line | 6545 FRANCE AVE S STE 400
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City | EDINA
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State | MN
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Zip | 55435-2115
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Country | US
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Telephone | 952-920-9191
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Fax | 952-920-0232
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Authorized Official
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Title or Position | BUSINESS OFFICE SUPERVISOR
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Name | FLORENCE WOOD
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Credential |
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Telephone | 952-920-9265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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