Organization
PEDI PEC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GRISELDA MILLER (ADMINISTRATOR)
(305) 623-1222
Entity
Organization
Contact information
Practice address
15839 NW 2ND AVE, MIAMI, FL 33169-6711
(305) 948-5683
Mailing address
1450 NW 159TH ST, MIAMI, FL 33169-5727
(305) 623-1222
Taxonomy
Speciality
Code
Description
License number
State
385HR2065X
Child Physical Disabilities Respite Care
Primary
60080975
FL
Other
Enumeration date
07/28/2006
Last updated
08/22/2020
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