NPI Code Details Logo

NPI 1871642603

NPI 1871642603 : PEDI PEC : MIAMI, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1871642603
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PEDI PEC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/10/2007
-----------------------------------------------------
    Last Update Date     |    09/11/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    15839 NW 2ND AVE 
-----------------------------------------------------
    City                 |    MIAMI
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33169-6711
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    305-948-5683
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    15839 NW 2ND AVE 
-----------------------------------------------------
    City                 |    MIAMI
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33169-6711
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PRESIDENT
-----------------------------------------------------
    Name                 |     GRISELDA  MILLER 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    305-623-1222
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    2279P3900X
-----------------------------------------------------
    Taxonomy Name        |    Neonatal/Pediatric Registered Respiratory Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    235Z00000X
-----------------------------------------------------
    Taxonomy Name        |    Speech-Language Pathologist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.