NPI 1790905305

Children's Medical Center, PA.

Organisation Exclusive Provider Organization Pembroke Pines, FL

Practice location

Address: 12251 Taft St, Pembroke Pines, FL 33026-1956
Phone: (954) 435-7000
Fax: (954) 435-7185

Authorised official

Name: Theodore Morrison
Title: President
Phone: (954) 989-6000

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence ME5015 (FL)

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Registry record

NPI: 1790905305
Entity type: Organization
NPI issued: 26 Apr 2007
Record last updated: 19 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.