Organization
PEDIATRIC SERVICES, INC.
Active
Other names
CSI, Special Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN SODERQUIST (ADMINISTRATOR)
(305) 821-1262
Entity
Organization
Contact information
Practice address
111 JFK DR STE B, ATLANTIS, FL 33462-6634
(561) 227-2052
(561) 967-8889
Mailing address
111 JFK DR STE B, ATLANTIS, FL 33462-6634
(561) 227-2052
(561) 967-8889
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
60081000
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003412103
—
FL
Enumeration date
12/26/2013
Last updated
12/26/2013
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