Provider Demographics
NPI:1306325246
Name:LOVING PEDIATRICS LLC
Entity type:Organization
Organization Name:LOVING PEDIATRICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:COYNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-829-9179
Mailing Address - Street 1:11893 OSPREY POINT CIR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8370
Mailing Address - Country:US
Mailing Address - Phone:954-829-9179
Mailing Address - Fax:
Practice Address - Street 1:12343 HAGEN RANCH RD UNIT 702
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-4194
Practice Address - Country:US
Practice Address - Phone:954-829-9179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care