PEDIATRIC HEALTH CARE ALLIANCE, PA
QID Q135056260 · NPI 1609965441
| Fact | Value | Period | Source |
|---|---|---|---|
| enumeration_date | {"date": "2006-10-12"} | 2006-10-12 | cms_nppes |
| legal_address | {"city": "OLDSMAR", "region": "FL", "street": "720 BROOKER CREEK BLVD STE 215", "country": | cms_nppes | |
| legal_name | {"value": "PEDIATRIC HEALTH CARE ALLIANCE, PA"} | cms_nppes | |
| provider_status | {"value": "aktiv", "deactivation_date": null, "reactivation_date": null} | cms_nppes | |
| provider_taxonomy | {"value": "103K00000X", "scheme": "NUCC"} | cms_nppes |
Cite as: FACTANKER, https://factanker.com/entity/a38a0986-b33b-4aa1-a36c-847ab14ebf65