PEDIATRIC HEALTH CARE ALLIANCE, PA
QID Q135411479 · NPI 1124325154
| Fact | Value | Period | Source |
|---|---|---|---|
| enumeration_date | {"date": "2011-02-28"} | 2011-02-28 | cms_nppes |
| legal_address | {"city": "ODESSA", "region": "FL", "street": "1850 CROSSINGS BLVD UNIT 100", "country": "U | 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": "208000000X", "scheme": "NUCC"} | cms_nppes |
Cite as: FACTANKER, https://factanker.com/entity/a7c22875-45f0-489e-8649-d3fb6fd4687d