# PEDIATRIX MEDICAL GROUP NEONATOLOGY AND PEDIATRIC INTENSIVE CARE SPECI

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376640078
- **Authorized official:** DR. KARIN JOHNSON (PRESIDENT)
- **Authorized official phone:** (800) 243-3839

## Contact information

- **Practice address:** 1301 CONCORD TER, SUNRISE, FL 33323-2843
- **Practice address phone:** (954) 384-0175
- **Practice address fax:** (954) 851-1948
- **Mailing address:** 4991 LAKE BROOK DR, SUITE 300, GLEN ALLEN, VA 23060-9293
- **Mailing address phone:** (804) 346-3535
- **Mailing address fax:** (804) 253-0408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2006
- **Last updated:** 11/05/2024