1225598626 NPI number — KIDZ MEDICAL SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225598626 NPI number — KIDZ MEDICAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KIDZ MEDICAL SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225598626
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5955 PONDE DE LEAON BLVD. C/O V CHEN,
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33146
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-661-1515
Provider Business Mailing Address Fax Number:
305-662-3723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 SW 62ND AVE STE 125
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33155-3009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-661-1515
Provider Business Practice Location Address Fax Number:
833-464-4208
Provider Enumeration Date:
03/21/2019

Additional Information

Authorized Official

Authorized Official Last Name:
CHEN
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED REPRESENTATIVE
Authorized Official Telephone Number:
305-661-1515

Provider Taxonomy Codes

  • Taxonomy code: 2080P0207X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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