Organization
VARIETY CHILDREN'S HOSPITAL
Active
Parent organization
MCH SPECIALIST CARDIOVASCULAR
Other names
Miami Children's Hoapital
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCH SPECIALIST CARDIOVASCULAR
Authorized official
TIMOTHY BIRKENSTOCK (SENIOR VP & CFO)
(305) 669-6422
Entity
Organization
Contact information
Practice address
3200 SW 60TH CT, SUITE 102, MIAMI, FL 33155-4000
(305) 663-8401
(305) 669-6574
Mailing address
PO BOX 863286, ORLANDO, FL 32886-3286
(305) 662-8334
(786) 624-2688
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255772001
—
FL
Enumeration date
04/25/2008
Last updated
10/29/2014
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