PEDIATRIC CARE CENTER, INC
Ambulatory Health in West Palm Beach, FL

License number
Florida ME0063404
Category
Ambulatory Health
Type
Primary Care
Owner
Name: HECTOR J DIAZ DE VILLEGAS M.D.
Title: OWNER
Phone: (561) 432-1822
Address
Address
2135 S. Congress Avenue. SUITE 2C-D, West Palm Beach, FL 33406
National Provider ID: 1396095998
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PEDIATRIC CARE CENTER, INC

2135 S Congress Ave BLDG #2 SUITE:C-D, West Palm Beach, FL 33406

Registration:
Jul 2, 1999
State ID:
P99000059924
Business type:
Florida Profit Corporation
Directors:
Hector J. Diaz Villegas, 2623 Yarmouth Dr, West Palm Beach, FL 33414 (Physical),Hector Diaz De Villegas (Director)
Agent:
Hector Diaz Villegas,2623 Yarmouth Dr, West Palm Beach, FL 33414 (Physical)
EIN:
65-0932823

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