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Organization
SOUTH FLORIDA PEDIATRIC SURGEONS PA
Active
Organization
SOUTH FLORIDA PEDIATRIC SURGEONS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKKI JO LEWARK (PRACTICE ADMINISTRATOR)
(954) 584-8500
Entity
Organization
Contact information
Practice address
300 N.W. 70TH AVENUE, SUITE 202, FT. LAUDERDALE, FL 33317-2384
(954) 584-8500
(954) 792-0192
Mailing address
300 N.W. 70TH AVENUE, SUITE 202, FT. LAUDERDALE, FL 33317-2384
(954) 584-8500
(954) 792-0192
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
NULL
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
02/03/2011
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