Organization
CSI-PEDIATRIC SERVICES, LLC
Active
Parent organization
PEDIATRIC HOLDINGS, LLC
Other names
Spark Pediatrics, CSI Special Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC HOLDINGS, LLC
Authorized official
DONNA LODATO RN (CEO)
(786) 522-9600
Entity
Organization
Contact information
Practice address
530 SW 1ST ST, SUITE 301-304, FLORIDA CITY, FL 33034-4806
(305) 967-0854
Mailing address
15050 NW 79TH CT STE 201, MIAMI LAKES, FL 33016-5810
(786) 522-9600
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024128600
—
FL
Enumeration date
07/16/2015
Last updated
07/13/2022
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