Organization
KIDZ DOC, PA
Active
Other names
KIDZ DOC, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL VEGA M.D. (PRESIDENT)
(305) 668-2144
Entity
Organization
Contact information
Practice address
6080 SW 40TH ST, SUITE 9, MIAMI, FL 33155-5233
(305) 668-2144
(305) 668-7791
Mailing address
6080 SW 40TH ST, SUITE 9, MIAMI, FL 33155-5233
(305) 668-2144
(305) 668-7791
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME54056
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062069600
—
FL
Enumeration date
09/06/2011
Last updated
09/06/2011
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