| Chcp-umed-pediatrics | |
|
1601 Nw 12th Ave Box 016960 M851 Miami FL 33136-1005 | |
| (305) 243-7688 | |
| (305) 243-8470 |
| Full Name | Chcp-umed-pediatrics |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1601 Nw 12th Ave, Miami, Florida |
| Authorized Official Name and Position | Julie Rowell (EX DIRECTOR, MANAGED CARE/BUSINESS) |
| Authorized Official Contact | 3052436837 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chcp-umed-pediatrics 1601 Nw 12th Ave Box 016960 M851 Miami FL 33136-1005 Ph: (305) 243-7688 | Chcp-umed-pediatrics 1601 Nw 12th Ave Box 016960 M851 Miami FL 33136-1005 Ph: (305) 243-7688 |
| NPI Number | 1790736148 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 11/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790736148 | NPI | - | NPPES |
| 0730734-00 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Primary |
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