Kool Kidz Pediatrics

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME73747 Issued in FL

Legal business name

KOOL KIDZ PEDIATRICS

Practice address

1951 SW 172ND Ave
Suite 410
Miramar, FL 33029-5593

Phone

(954) 433-1966

Fax

(954) 433-3466

NPI assigned

Jun 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Valia Moreno

Title

Office Manager

Phone

(954) 433-1966

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1184884918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVE",
            "address_2": "SUITE 410",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295593",
            "telephone_number": "954-433-1966",
            "fax_number": "954-433-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVE",
            "address_2": "SUITE 410",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295593",
            "telephone_number": "954-433-1966",
            "fax_number": "954-433-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOL KIDZ PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "VALIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-433-1966"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME73747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "254343",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274336100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "42955",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "537102",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JMH",
            "identifier": "53941",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253373100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "053586",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "207345",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew T Kleese, DO
• Atsou Klougan
• Laura K. Knox
• Sudha Ranga Naga Koganti
• Bryant Kwangman Koh, MD
• Sarah Koplow, APRN
• Damian Korsich, MD
• James W. Kramer, MD, FACS
• Nicole Marie Kriske, DO
• KT'S Superior Care Inc

• Primary Care Clinic/Center in Miramar, FL
• Providers in Miramar, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.