Organization
PEDIATRIC MD SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE PAVLOU MD (PRESIDENT/CEO)
(561) 736-2510
Entity
Organization
Contact information
Practice address
1325 S CONGRESS AVE, SUITE 109, BOYNTON BEACH, FL 33426-5876
(561) 736-2510
(561) 503-4873
Mailing address
1325 S CONGRESS AVE, SUITE 109, BOYNTON BEACH, FL 33426-5876
(561) 736-2510
(561) 503-4873
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME90011
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270305000
—
FL
Enumeration date
10/30/2007
Last updated
09/21/2008
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