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General NPI Number Information
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NPI Number | 1932512910
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Entity Type | Organization
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Legal Business Name | VARIETY CHILDREN'S HOSPITAL
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Dates
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Enumeration Date | 06/06/2014
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 7886 W SAMPLE RD
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City | MARGATE
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State | FL
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Zip | 33065-4710
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Country | US
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Telephone | 954-442-0809
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Fax | 954-442-0704
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Provider Business Mailing Address
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Address Line | PO BOX 863941
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City | ORLANDO
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State | FL
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Zip | 32886-3941
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Country | US
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Telephone | 305-662-8334
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Fax |
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Authorized Official
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Title or Position | SENIOR VP & CFO
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Name | TIMOTHY BIRKENSTOCK
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Credential |
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Telephone | 305-669-6422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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