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General NPI Number Information
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NPI Number | 1700055407
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Entity Type | Organization
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Legal Business Name | PEDIATRICS ALLIANCE, LLC
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 2100 45TH ST SUITE 200
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2016
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Country | US
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Telephone | 561-840-1500
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Fax | 561-840-1505
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Provider Business Mailing Address
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Address Line | 2100 45TH ST SUITE 200
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2016
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Country | US
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Telephone | 561-840-1500
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Fax | 561-840-1505
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. STEVEN TAKAS
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Credential | M.D.
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Telephone | 561-840-1500
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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 | ME90852
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License Number State | FL
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