# SOUTH FLORIDA PEDIATRIC SURGEONS PA

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

## Provider details

- **NPI number:** 1962512061
- **Authorized official:** MRS. NIKKI JO LEWARK (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (954) 584-8500

## Contact information

- **Practice address:** 300 N.W. 70TH AVENUE, SUITE 202, FT. LAUDERDALE, FL 33317-2384
- **Practice address phone:** (954) 584-8500
- **Practice address fax:** (954) 792-0192
- **Mailing address:** 300 N.W. 70TH AVENUE, SUITE 202, FT. LAUDERDALE, FL 33317-2384
- **Mailing address phone:** (954) 584-8500
- **Mailing address fax:** (954) 792-0192

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 02/03/2011