Organization
PSA PEDIATRIC NEPHROLOGY
Active
Parent organization
PEDIATRIC SPECIALTY GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC SPECIALTY GROUP, INC.
Authorized official
MR. TIMOTHY BIRKENSTOCK (SVP & CFO FOR MCHS)
(305) 669-6422
Entity
Organization
Contact information
Practice address
1665 MEDICAL BLVD, NAPLES, FL 34110-1402
(305) 662-8352
(305) 669-6545
Mailing address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(305) 662-8352
(305) 669-6545
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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