PEDIATRIC HEALTH CARE ALLIANCE, PA
QID Q135190972 · NPI 1619643566
| Fact | Value | Period | Source |
|---|---|---|---|
| enumeration_date | {"date": "2021-08-20"} | 2021-08-20 | cms_nppes |
| legal_address | {"city": "LUTZ", "region": "FL", "street": "1854 OAK GROVE BLVD", "country": "US", "format | 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/bc66703d-7e86-44d1-bdf7-45797cd05026