Basic Information
Provider Information
NPI: 1316293053
EntityType: 2
ReplacementNPI:  
OrganizationName: MIAMI CHILDREN'S HOSPITAL
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 8960 NW 8TH ST APT 203
Address2:  
City: MIAMI
State: FL
PostalCode: 331723407
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3100 SW 62ND AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331553009
CountryCode: US
TelephoneNumber: 3056666511
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/31/2012
LastUpdateDate: 07/31/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SHARMA
AuthorizedOfficialFirstName: KAMAL
AuthorizedOfficialMiddleName: PRASAD
AuthorizedOfficialTitleorPosition: MD
AuthorizedOfficialTelephone: 3056666511
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282NC2000X107533FLY HospitalsGeneral Acute Care HospitalChildren

No ID Information.


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