Organization
PLANTATION PEDIATRIC NEUROSURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG WALKER (VP)
(954) 475-9244
Entity
Organization
Contact information
Practice address
350 NW 84TH AVE, SUITE 108, PLANTATION, FL 33324-1817
(954) 475-9244
Mailing address
350 NW 84TH AVE, SUITE 108, PLANTATION, FL 33324-1817
(954) 475-9244
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94737
BCBS OF FL
FL
Enumeration date
06/08/2006
Last updated
04/20/2008
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