Organization
VARIETY CHILDREN'S HOSPITAL
Active
Parent organization
MIAMI CHILDREN'S HOSPITAL
Other names
MCH Specialist
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIAMI CHILDREN'S HOSPITAL
Authorized official
TIMOTHY BIRKENSTOCK (SENIOR VP & CFO)
(305) 669-6422
Entity
Organization
Contact information
Practice address
12989 SOUTHERN BLVD, PALMS WEST MOB III SUITE 203, LOXAHATCHEE, FL 33470-9211
(561) 383-7113
Mailing address
PO BOX 863941, ORLANDO, FL 32886-3941
(305) 662-8334
(786) 624-2688
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255772027
—
FL
Enumeration date
04/19/2010
Last updated
10/29/2014
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