Organization
CLYDE PARK PEDIATRICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLOR BORRERO M.D. (OWNER)
(616) 808-3265
Entity
Organization
Contact information
Practice address
3637 CLYDE PARK AVE SW STE 4, WYOMING, MI 49509
(616) 808-3265
(616) 726-7019
Mailing address
3637 CLYDE PARK AVE SW STE 4, WYOMING, MI 49509
(616) 808-3265
(616) 726-7019
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301066741
MI
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
07/13/2006
Last updated
06/10/2014
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