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Organization

CHILDRENS DIAGNOSTIC & TREATMENT CENTER INC

Active
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Organization

CHILDRENS DIAGNOSTIC & TREATMENT CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANA CALDERON-RANDAZZO PHD (ADMINSTRATOR)
(954) 728-1060
Entity
Organization

Contact information

Practice address
1401 S FEDERAL HWY, FORT LAUDERDALE, FL 33316-2619
(954) 728-8080
(954) 779-1957
Mailing address
1700 NW 49TH ST STE 125, FORT LAUDERDALE, FL 33309-3750
(954) 728-8080
(954) 779-1957

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
FL
1041C0700X
Clinical Social Worker
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006458400
FL
01
34478
BCBS
FL
Enumeration date
08/21/2009
Last updated
02/02/2026
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