Prime Pediatric Associates, LLC

NPI #1023368164 in Pompano Beach, Florida

Provider Information

NPI Number: 1023368164
Entity Type: Organization
Organization Name: Prime Pediatric Associates, LLC
Primary Specialty: Pediatrics
Enumeration Date: Sep 17, 2012
Last Updated: Sep 17, 2012

Practice Location

Address: 100 E SAMPLE RD
Address 2: STE 120
City: Pompano Beach
State: Florida
ZIP Code: 33064-3554
Phone: (954) 941-2021

Authorized Official

Name: DIBANNI VASQUEZ, M.D.
Title: MGRM
Phone: (305) 972-1073

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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