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General NPI Number Information
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NPI Number | 1629173943
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Entity Type | Organization
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Legal Business Name | BRICKELL PEDIATRICS, P.A.
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1799 SW 3RD AVE
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City | MIAMI
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State | FL
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Zip | 33129-1492
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Country | US
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Telephone | 305-858-6626
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Fax |
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Provider Business Mailing Address
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Address Line | 1799 SW 3RD AVE
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City | MIAMI
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State | FL
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Zip | 33129-1492
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Country | US
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Telephone | 305-858-6626
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MONICA REINA
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Credential | M.D.
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Telephone | 305-858-3737
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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 | ME74377
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License Number State | FL
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