The Pediatric Office, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME0017052 Issued in FL

Legal business name

THE PEDIATRIC OFFICE, PA

Practice address

14201 W Sunrise Blvd
Suite 107
Sunrise, FL 33323-3207

Phone

(954) 835-2111

Fax

(954) 835-1105

NPI assigned

Jan 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael A Halle, MD

Title

President

Phone

(954) 835-2111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1457407678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD",
            "address_2": "SUITE 107",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233207",
            "telephone_number": "954-835-2111",
            "fax_number": "954-835-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD",
            "address_2": "SUITE 107",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233207",
            "telephone_number": "954-835-2111",
            "fax_number": "954-835-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC OFFICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-28",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "HALLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-835-2111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0017052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.