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Organization

EAST/WEST PEDIATRICS, P.A.

Active
Parent organization
EAST/WEST PEDIATRICS, P.A.
Organization subpart
Yes

Provider details

NPI number
Legal business name
EAST/WEST PEDIATRICS, P.A.
Authorized official
MRS. RAGINI DHARMAPPA (OFFICE MANAGER)
(954) 452-7576
Entity
Organization

Contact information

Practice address
106 NW 100TH AVE, PLANTATION, FL 33324-7008
(954) 452-7576
(954) 452-8248
Mailing address
106 NW 100TH AVE, PLANTATION, FL 33324-7008
(954) 452-7576
(954) 452-8248

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME0037089
FL
208000000X
Pediatrics Physician
Primary
ME0037416
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME0037089
STATE LICENSE
FL
01
ME0037416
ST LICENSE
FL
Enumeration date
04/18/2006
Last updated
05/15/2008
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