Provider Demographics
NPI:1871051599
Name:AFFILIATED PEDIATRICS OF SOUTH FLORIDA LLC
Entity type:Organization
Organization Name:AFFILIATED PEDIATRICS OF SOUTH FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAQUINTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYPPLOLITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-966-7337
Mailing Address - Street 1:3829 HOLLYWOOD BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6790
Mailing Address - Country:US
Mailing Address - Phone:954-966-7337
Mailing Address - Fax:
Practice Address - Street 1:3829 HOLLYWOOD BLVD STE A
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6790
Practice Address - Country:US
Practice Address - Phone:954-966-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty