Organization
CSI PEDIATRIC SERVICES, LLC.
Active
Parent organization
PEDIATRIC HOLDINGS, LLC
Other names
Spark Pediatrics, CSI Special Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC HOLDINGS, LLC
Authorized official
DONNA LODATO RN (CEO)
(786) 522-9600
Entity
Organization
Contact information
Practice address
7054 W COLONIAL DR, ORLANDO, FL 32818-6739
(407) 867-3847
(407) 822-5715
Mailing address
15050 NW 79TH CT STE 201, MIAMI LAKES, FL 33016-5810
(786) 522-9600
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024132900
—
FL
Enumeration date
04/22/2014
Last updated
07/13/2022
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