Organization
CHILDRENS DIAGNOSTIC & TREATMENT CENTER INC
Active
Other names
TCM Group
Organization subpart
No
Provider details
NPI number
Authorized official
ANA CALDERON RANDAZZO PHD (ADMINISTRATOR)
(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
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055049300
—
FL
01
—
34478
BCBS
FL
Enumeration date
04/17/2007
Last updated
01/30/2023
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