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NPI Code Detail

MEDICARE: SOUTH FLORIDA PEDIATRIC CHRONIC CARE LLC

MEDICARE: SOUTH FLORIDA PEDIATRIC CHRONIC CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianL13000028574FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497198444
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH FLORIDA PEDIATRIC CHRONIC CARE LLC
Provider Business Mailing Address
First Line : 1117 E HALLANDALE BEACH BLVD
Second Line :
City : HALLANDALE BEACH
State : FL
Zip : 33009-4488
Country : US
Telephone Number : 954-454-5131
Fax Number : 954-241-6908
Provider Business Practice Location Address
First Line : 1117 E HALLANDALE BEACH BLVD
Second Line :
City : HALLANDALE BEACH
State : FL
Zip : 33009-4488
Country : US
Telephone Number : 954-454-5131
Fax Number : 954-241-6908
Authorized Official
Title or Position : PRESIDENT
Name : DR. ALLAN GREISSMAN
Credential : MD
Telephone Number : 954-454-5131
Provider Enumeration Date : 04/09/2013
Last Update Date : 05/20/2013

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Directions to “SOUTH FLORIDA PEDIATRIC CHRONIC CARE LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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