Organization
EAST/WEST PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAGINI DHARMAPPA (OFFICE MANAGER)
(954) 452-7576
Entity
Organization
Contact information
Practice address
1319 SE 2ND AVE, FT LAUDERDALE, FL 33316-1809
(954) 467-3053
(954) 467-5424
Mailing address
1319 SE 2ND AVE, FT LAUDERDALE, FL 33316-1809
(954) 467-3053
(954) 467-5424
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME0037089
FL
208000000X
Pediatrics Physician
Primary
ME0037416
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24762
FL BLUE CROSS/BLUE SHIELD
FL
05
—
374383700
—
FL
Enumeration date
04/13/2006
Last updated
05/15/2008
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