Organization
VARIETY CHILDERN'S HOSPITAL
Active
Other names
MCH Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BIRKENSTOCK (SENIOR VP & CFO)
(305) 669-6422
Entity
Organization
Contact information
Practice address
13400 SW 120TH ST, SUITE 100 & 200, MIAMI, FL 33186-7440
(786) 624-5363
Mailing address
PO BOX 863942, ORLANDO, FL 32886-3942
(305) 662-8334
(786) 624-2688
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256985007
—
FL
Enumeration date
04/20/2009
Last updated
10/29/2014
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