Organization
KOOL KIDZ PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALIA MORENO (OFFICE MANAGER)
(954) 433-1966
Entity
Organization
Contact information
Practice address
1951 SW 172ND AVE, SUITE 410, MIRAMAR, FL 33029-5593
(954) 433-1966
(954) 433-3466
Mailing address
1951 SW 172ND AVE, SUITE 410, MIRAMAR, FL 33029-5593
(954) 433-1966
(954) 433-3466
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME73747
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053586
NHP
FL
01
—
207345
AMERIGROUP
FL
05
—
253373100
—
FL
01
—
254343
AVMED
FL
05
—
274336100
—
FL
01
—
42955
BCBS
FL
01
—
537102
CIGNA
FL
01
—
53941
JMH
FL
Enumeration date
06/16/2008
Last updated
06/16/2008
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