Provider Demographics
NPI:1144664442
Name:HAPPY KIDZ PEDIATRICS, PL
Entity type:Organization
Organization Name:HAPPY KIDZ PEDIATRICS, PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANOOP
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:PALTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-446-1583
Mailing Address - Street 1:PO BOX 6039
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33807-6039
Mailing Address - Country:US
Mailing Address - Phone:863-446-1583
Mailing Address - Fax:
Practice Address - Street 1:4304 HIGHLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1647
Practice Address - Country:US
Practice Address - Phone:863-446-1583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96413261QP2300X
FLME98082261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care