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NPI Code Detail

MEDICARE: PEDIATRIC PROVIDERS OF S. FLA

MEDICARE: PEDIATRIC PROVIDERS OF S. FLA
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 Physician

General Provider Information

NPI Number : 1891883484
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC PROVIDERS OF S. FLA
Provider Business Mailing Address
First Line : 464 W 51ST PL
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3620
Country : US
Telephone Number : 305-557-1281
Fax Number : 305-362-9138
Provider Business Practice Location Address
First Line : 464 W 51ST PL
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3620
Country : US
Telephone Number : 305-557-1281
Fax Number : 305-362-9138
Authorized Official
Title or Position : OWNER
Name : DR. JORGE LUIS CABRERA
Credential : M.D.
Telephone Number : 305-557-1281
Provider Enumeration Date : 10/10/2006
Last Update Date : 08/22/2020

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Directions to “PEDIATRIC PROVIDERS OF S. FLA ” Practice Location

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