Provider Demographics
NPI:1447536487
Name:CORAL SPRINGS HOLISTIC PEDIATRICS, LLC
Entity type:Organization
Organization Name:CORAL SPRINGS HOLISTIC PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-295-3917
Mailing Address - Street 1:9750 NW 33RD ST
Mailing Address - Street 2:SUITE # 216
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4042
Mailing Address - Country:US
Mailing Address - Phone:954-752-8446
Mailing Address - Fax:954-752-8464
Practice Address - Street 1:9750 NW 33RD ST
Practice Address - Street 2:SUITE # 216
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4042
Practice Address - Country:US
Practice Address - Phone:954-752-8446
Practice Address - Fax:954-752-8464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty