Organization
PRIME PEDIATRIC ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIBANNI VASQUEZ M.D. (MGRM)
(305) 972-1073
Entity
Organization
Contact information
Practice address
100 E SAMPLE RD, STE 120, POMPANO BEACH, FL 33064-3554
(954) 941-2021
(954) 941-2071
Mailing address
100 E SAMPLE RD, STE 120, POMPANO BEACH, FL 33064-3554
(954) 941-2021
(954) 941-2071
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME109534
FL
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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