Provider Demographics
NPI:1336967090
Name:GROWING TOGETHER PEDIATRIC MEDICAL PC
Entity type:Organization
Organization Name:GROWING TOGETHER PEDIATRIC MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:BIENVENIDO
Authorized Official - Last Name:FLORIMON DE LA ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-296-2020
Mailing Address - Street 1:8714 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-2036
Mailing Address - Country:US
Mailing Address - Phone:718-296-2020
Mailing Address - Fax:718-296-1781
Practice Address - Street 1:8714 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2036
Practice Address - Country:US
Practice Address - Phone:718-296-2020
Practice Address - Fax:718-296-1781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty