Organization
PEDIATRIC MEDICAL ASSOCIATES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD BRANSTETTER (CFO)
(800) 990-0340
Entity
Organization
Contact information
Practice address
4445 PINE FOREST DR, LAKE WORTH, FL 33463-4676
(800) 990-0340
Mailing address
PO BOX 542590, GREENACRES, FL 33454-2590
(800) 990-0340
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
09/26/2013
Last updated
02/26/2014
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