Organization
PEDIATRIX EMERGENT AND CRITICAL CARE SERVICES, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY LACAZE (AUTHORIZED SIGNATORY)
(888) 822-2855
Entity
Organization
Contact information
Practice address
3001 E PRESIDENT GEORGE BUSH HWY, SUITE 250, RICHARDSON, TX 75082-3542
(800) 243-3839
(954) 858-0434
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
(954) 858-0434
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1812692
—
LA
Enumeration date
07/23/2009
Last updated
04/03/2014
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