# CHILDRENS DIAGNOSTIC & TREATMENT CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TCM Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962628289
- **Authorized official:** ANA CALDERON RANDAZZO PHD (ADMINISTRATOR)
- **Authorized official phone:** (954) 728-1060

## Contact information

- **Practice address:** 1401 S FEDERAL HWY, FORT LAUDERDALE, FL 33316-2619
- **Practice address phone:** (954) 728-8080
- **Practice address fax:** (954) 779-1957
- **Mailing address:** 1700 NW 49TH ST STE 125, FORT LAUDERDALE, FL 33309-3750
- **Mailing address phone:** (954) 728-8080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 01/30/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 055049300 | — | FL |
| 01 | — | 34478 | BCBS | FL |