Provider Demographics
NPI:1447353909
Name:PERSONAL CARE PEDIATRICS
Entity type:Organization
Organization Name:PERSONAL CARE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & MD
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAGALETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:854-974-3006
Mailing Address - Street 1:2964 N STATE ROAD 7
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5715
Mailing Address - Country:US
Mailing Address - Phone:954-974-3006
Mailing Address - Fax:954-974-8921
Practice Address - Street 1:2964 N STATE ROAD 7
Practice Address - Street 2:SUITE 340
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5715
Practice Address - Country:US
Practice Address - Phone:954-974-3006
Practice Address - Fax:954-974-8921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2021-05-25
Deactivation Date:2019-02-20
Deactivation Code:
Reactivation Date:2019-03-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378080500Medicaid