Organization
MANOR PLAZA PEDIATRIC & GENERAL MEDICINE INC.
Active
Other names
MINOR PLAZA PEDIATRIC AND GENERAL MEDICINE, MANOR PLAZA PEDIATRIC AND GENERAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HELENA M GAVIRIA M.D. (MEDICAL DIRECTOR)
(954) 779-1667
Entity
Organization
Contact information
Practice address
1234 NE 4TH AVE SUITE A, FORT LAUDERDALE, FL 33304-1925
(954) 779-1667
(954) 760-7253
Mailing address
1234 NE 4TH AVE STE A, FORT LAUDERDALE, FL 33304-1977
(954) 779-1667
(954) 760-7253
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0042195
FL
208D00000X
General Practice Physician
ME0042195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062870100
—
FL
Enumeration date
06/22/2011
Last updated
03/06/2026
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