Organization
VARIETY CHILDREN'S HOSPITAL
Active
Other names
MCH Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BIRKENSTOCK (SENIOR VP & CFO)
(305) 669-6422
Entity
Organization
Contact information
Practice address
17615 SW 97TH AVE, PALMETTO BAY, FL 33157-5636
(786) 268-2600
Mailing address
PO BOX 863941, ORLANDO, FL 32886-3941
(305) 662-8334
(786) 624-2688
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207YP0228X
Pediatric Otolaryngology Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
2080P0207X
Pediatric Hematology & Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255772025
—
FL
Enumeration date
04/02/2009
Last updated
10/29/2014
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