Organization
VARIETY CHILDREN'S HOSPITAL
Active
Other names
MCH Nicklaus Outpatient Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BIRKENSTOCK (VP & CFO)
(305) 666-6511
Entity
Organization
Contact information
Practice address
11310 LEGACY AVE, PALM BEACH GARDENS, FL 33410-3658
(305) 666-6511
Mailing address
PO BOX 557367, MIAMI, FL 33255-7367
(786) 624-5845
(786) 624-2688
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006315101
—
FL
Enumeration date
03/06/2012
Last updated
09/19/2013
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