Organization
ADVANCED PEDIATRICS PPEC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN A RODRIGUEZ (PRESIDENT/ADMINISTRATOR)
(786) 560-9069
Entity
Organization
Contact information
Practice address
10383 SW 186TH ST, CUTLER BAY, FL 33157-6824
(786) 560-9069
Mailing address
10383 SW 186TH ST, CUTLER BAY, FL 33157-6824
(786) 560-9069
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
—
—
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
—
—
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
—
—
3140N1450X
Pediatric Skilled Nursing Facility
—
—
Other
Enumeration date
04/07/2021
Last updated
11/22/2021
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