1447353909 NPI number — PERSONAL CARE PEDIATRICS

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 1447353909 NPI number — PERSONAL CARE PEDIATRICS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERSONAL CARE PEDIATRICS
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:
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:
1447353909
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/20/2019
NPI Reactivation Date:
03/09/2019

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2964 N STATE ROAD 7 STE 340
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARGATE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33063-5715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-974-3006
Provider Business Mailing Address Fax Number:
954-974-8921

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2964 N STATE ROAD 7
Provider Second Line Business Practice Location Address:
SUITE 340
Provider Business Practice Location Address City Name:
MARGATE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33063-5715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-974-3006
Provider Business Practice Location Address Fax Number:
954-974-8921
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEVINSON
Authorized Official First Name:
NADIA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
561-715-3900

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 378080500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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