Provider Demographics
NPI:1386956084
Name:THE CHILDREN MEDICAL CENTER GROUP INC.
Entity type:Organization
Organization Name:THE CHILDREN MEDICAL CENTER GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORP. SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:GILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-225-4434
Mailing Address - Street 1:8300 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4100
Mailing Address - Country:US
Mailing Address - Phone:305-225-4434
Mailing Address - Fax:305-279-9466
Practice Address - Street 1:8300 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4100
Practice Address - Country:US
Practice Address - Phone:305-225-4434
Practice Address - Fax:305-279-9466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME14590208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty