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General NPI Number Information
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NPI Number | 1952463978
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Entity Type | Organization
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Legal Business Name | CARMEN PEDIATRIC CARE CENTER, INC.
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2589 N. STATE ROAD 7
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City | LAUDERHILL
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State | FL
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Zip | 33313
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Country | US
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Telephone | 954-731-4474
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Fax | 954-731-4472
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Provider Business Mailing Address
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Address Line | 2589 N. STATE ROAD 7
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City | LAUDERHILL
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State | FL
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Zip | 33313
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Country | US
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Telephone | 954-731-4474
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | JACQUELINE PHILIPPOUSSI
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Credential |
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Telephone | 954-731-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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