Provider Demographics
NPI:1053558460
Name:CHILDRENS ENDOCRINE & DIABETES CARE INC
Entity type:Organization
Organization Name:CHILDRENS ENDOCRINE & DIABETES CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MIDDEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-792-1525
Mailing Address - Street 1:1447 MEDICAL PARK BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:561-792-1525
Mailing Address - Fax:561-792-1521
Practice Address - Street 1:1447 MEDICAL PARK BLVD
Practice Address - Street 2:STE 104
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-792-1525
Practice Address - Fax:561-792-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Single Specialty