Organization
CHILDREN'S MEDICAL CENTER, PA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE MORRISON M.D. (PRESIDENT)
(954) 989-6000
Entity
Organization
Contact information
Practice address
20170 PINES BLVD, SUITE 203, PEMBROKE PINES, FL 33029-1259
(954) 378-1500
(954) 378-1530
Mailing address
20170 PINES BLVD, SUITE 203, PEMBROKE PINES, FL 33029-1259
(954) 378-1500
(954) 378-1530
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
ME5015
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060425902
—
FL
Enumeration date
04/23/2007
Last updated
09/19/2011
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