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Organization
NICKLAUS CHILDREN'S HOSPITAL PALM BEACH GARDENS OUTPATIENT CENTER
Active
Organization
NICKLAUS CHILDREN'S HOSPITAL PALM BEACH GARDENS OUTPATIENT CENTER
Active
Parent organization
VARIETY CHILDREN'S HOSPITAL
Other names
Nicklaus Children's Palm Beach Gardens Outpatient Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
VARIETY CHILDREN'S HOSPITAL
Authorized official
RAIZA VIDAURRAZAGA (MANAGER, PROVIDER RELATIONS)
(786) 525-5405
Entity
Organization
Contact information
Practice address
11310 LEGACY AVE, PALM BEACH GARDENS, FL 33410-3658
(305) 666-6511
Mailing address
PO BOX 557367, MIAMI, FL 33255-7367
(786) 624-5876
(786) 624-2688
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
282NC2000X
Children's Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010060930
—
FL
Enumeration date
02/15/2012
Last updated
03/15/2018
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