Pediatric Providers of S Florida

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

ME49402 Issued in FL

Legal business name

PEDIATRIC PROVIDERS OF S FLORIDA

Practice address

464 W 51St PL
Hialeah, FL 33012-3620

Phone

(305) 551-1281

Fax

(305) 362-9138

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Direndia Shackelford

Title

Managed Care Spec- Allscripts

Phone

(800) 680-0889

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• JORGE L CABRERA MD Doing business as

Tax ID family

Jorge L Cabrera MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Providers of S. Fla

  • Pediatrics Physician
  • Hialeah, FL
  • NPI 1891883484
  NPD tax ID

Locations

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275554248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 W 51ST PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 W 51ST PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123620",
            "telephone_number": "305-551-1281",
            "fax_number": "305-362-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PROVIDERS OF S FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "DIRENDIA",
        "authorized_official_title_or_position": "MANAGED CARE SPEC- ALLSCRIPTS",
        "authorized_official_telephone_number": "800-680-0889"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME49402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1017854",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JORGE L CABRERA MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pediatric & Family Urgent Care CTRS of So. Fla Inc.
• Pediatric &Adolescent Medicine
• Pediatric and Family Clinics
• Pediatric Dental & Orthodontics Specialists, PA
• Pediatric Dentistry Inc
• Pediatric Providers of S. Fla
• Pediatric Rehab Services LLC
• Pediatric Rehabilitation Care Group LLC
• Pediatric Speech and Behavioral Therapy of Miami LLC
• Pediatric Therapist Group Inc

• Non-Pharmacy Dispensing Site in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.