| One Source Pediatrics P.a | |
|
1625 N Commerce Pkwy Suite 205 Weston FL 33326-3216 | |
| (954) 659-8550 | |
| (954) 659-8770 |
| Full Name | One Source Pediatrics P.a |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1625 N Commerce Pkwy, Weston, Florida |
| Authorized Official Name and Position | Carlos Orlando Barbosa (OWNER) |
| Authorized Official Contact | 9546598550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| One Source Pediatrics P.a 1625 N Commerce Pkwy Suite 205 Weston FL 33326-3216 Ph: (954) 659-8550 | One Source Pediatrics P.a 1625 N Commerce Pkwy Suite 205 Weston FL 33326-3216 Ph: (954) 659-8550 |
| NPI Number | 1346266962 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 07/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346266962 | NPI | - | NPPES |
| 262872400 | Medicaid | FL | |
| 266448800 | Medicaid | FL | |
| 048013401 | Medicaid | FL | |
| 271831600 | Medicaid | FL | |
| 271158300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME83660 (Florida) | Primary |
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