Organization
PEDIATRIX MEDICAL MANAGEMENT GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL B WAGNER (PRESIDENT)
(954) 384-0175
Entity
Organization
Contact information
Practice address
1400 E BOULDER ST, COLORADO SPRINGS, CO 80909-5533
(719) 447-8812
(719) 447-8987
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(954) 384-0175
(954) 851-1948
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
Other
Enumeration date
07/27/2006
Last updated
10/08/2008
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