NPIMap

Organization Active NPI

Variety Childrens Hospital

  • Pediatric Radiology Physician
  • Doral, FL
National Provider Identifier
1669632105
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
Legal business name
VARIETY CHILDRENS HOSPITAL
Doing business as
MCH Radiology
Practice address
3601 NW 107TH Ave
Doral, FL 33178-4377
Phone
(768) 624-3675
NPI assigned
Jun 9, 2008
Organization subpart
Yes
Parent organization
MIAMI CHILDRENS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Timothy Birkenstock
Title
Senior VP & Cfo
Phone
(305) 669-6422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085P0229X Primary

Addresses

Primary practice location

3601 NW 107TH Ave
Doral, FL 33178-4377

Mailing address

PO Box 863942
Orlando, FL 32886-3942
Phone (305) 662-8334

Other identifiers 1

IdentifierTypeStateIssuer
256985003MedicaidFL

Other names 1

  • MCH Radiology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Variety Children'S Hospital5 organizations share this tax ID, including this one
Part of
Variety Children'S Hospital

Other organizations with this tax ID 4

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1669632105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863942",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863942",
            "telephone_number": "305-662-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 NW 107TH AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784377",
            "telephone_number": "768-624-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARIETY CHILDRENS HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIAMI CHILDRENS HOSPITAL",
        "enumeration_date": "2008-06-09",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "BIRKENSTOCK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "SENIOR VP & CFO",
        "authorized_official_telephone_number": "305-669-6422"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256985003",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCH Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.