MEDICARE: CHILDRENS MEDICAL ASSOCIATION PA

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
1	208000000X	Pediatrics Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1942393749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDRENS MEDICAL ASSOCIATION PA

Provider Business Mailing Address
First Line	:	8430 W BROWARD BLVD STE 300
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-2700
Country	:	US
Telephone Number	:	954-473-1011
Fax Number	:	954-473-8588

Provider Business Practice Location Address
First Line	:	8430 W BROWARD BLVD STE 300
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-2700
Country	:	US
Telephone Number	:	954-473-1011
Fax Number	:	954-473-8588

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LAKESHA SHAH
Credential	:
Telephone Number	:	954-722-0300

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/20/2021

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Directions to “CHILDRENS MEDICAL ASSOCIATION PA ” Practice Location

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