# CHILDREN'S MEDICAL CENTER, PA.

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

## Provider details

- **NPI number:** 1790905305
- **Authorized official:** THEODORE MORRISON M.D. (PRESIDENT)
- **Authorized official phone:** (954) 989-6000

## Contact information

- **Practice address:** 12251 TAFT ST, PEMBROKE PINES, FL 33026-1956
- **Practice address phone:** (954) 435-7000
- **Practice address fax:** (954) 435-7185
- **Mailing address:** 12251 TAFT ST, PEMBROKE PINES, FL 33026-1956
- **Mailing address phone:** (954) 435-7000
- **Mailing address fax:** (954) 435-7185

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | ME5015 | FL | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 09/19/2011