PEDIATRIC HEALTH CARE ALLIANCE, PA
QID Q135411218 · NPI 1730486762
| Fact | Value | Period | Source |
|---|---|---|---|
| enumeration_date | {"date": "2011-02-28"} | 2011-02-28 | cms_nppes |
| legal_address | {"city": "LITHIA", "region": "FL", "street": "5621 SKYTOP DR", "country": "US", "formatted | 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/b14701af-d870-4faa-861b-44059ea7413a