Minor Plaza Pediatric And General Medicine
LBN: Manor Plaza Pediatric Center Inc
Minor Plaza Pediatric And General Medicine is an health care organization with primary practice located at 1234 Ne 4Th Ave , Fort Lauderdale FL 33304-1925. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Pediatrics is the primary health care specialty.
Manor Plaza Pediatric Center Inc can be contacted via phone (954) 779-1667, or through Mathieu, Jean-Wilner via phone (954) 779-1667.
Contact Information
Primary practice address
1234 Ne 4Th Ave
Fort Lauderdale FL 33304-1925
Phone: (954) 779-1667
Fax: (954) 760-7253
Website:
Authorized official contact:
Name: Mathieu, Jean-Wilner Doctor of Medicine (MD)
Phone: (954) 779-1667
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME0042195 | Florida |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ME0042195 | Florida |
Profile Details
| NPI number | 1558657130 |
|---|---|
| LBN Legal business name | Manor Plaza Pediatric Center Inc |
| DBA Doing business as | Minor Plaza Pediatric And General Medicine |
| Authorized official | Mathieu, Jean-Wilner Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 22nd, 2011 |
| Last updated | Feb 16th, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558657130 | NPPES |
| Florida | MEDICAID | 062870100 |
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