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General NPI Number Information
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NPI Number | 1902268790
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Entity Type | Organization
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Legal Business Name | GERALDI PEDIATRIC CENTER
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 11246 SW 137TH AVE
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City | MIAMI
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State | FL
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Zip | 33186-4201
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Country | US
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Telephone | 305-382-0022
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Fax | 305-383-2174
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Provider Business Mailing Address
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Address Line | 11246 SW 137TH AVE
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City | MIAMI
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State | FL
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Zip | 33186-4201
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Country | US
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Telephone | 305-382-0022
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Fax | 305-383-2174
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GERMAN FERRER
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Credential |
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Telephone | 786-299-9529
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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 | ME0055384
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License Number State | FL
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