Organization
CHILDRENS DIAGNOSTIC & TREATMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANA CALDERON RANDAZZO PHD (ADMINISTRATOR)
(954) 728-1060
Entity
Organization
Contact information
Practice address
1401 S FEDERAL HWY, FORT LAUDERDALE, FL 33316
(954) 728-8080
Mailing address
1608 SE 3RD AVE FL 3, FORT LAUDERDALE, FL 33316-2564
(954) 728-8080
(954) 779-1957
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
208000000X
Pediatrics Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061258800
—
FL
05
—
061258803
—
FL
01
—
34478
BCBS
FL
Enumeration date
10/05/2006
Last updated
02/02/2026
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