OrganizationEast/West Pediatrics, P.A.PediatricsAllopathic & Osteopathic PhysiciansPractice Address106 NW 100th Ave, Plantation, FL 33324-7008(954) 452-7576PECOS EnrollmentBased on the most recent information from CMS, provider East/West Pediatrics, P.A. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1114982899Provider TypeOrganizationFull NameEast/West Pediatrics, P.A.SubpartYesEnumeration Date4/18/2006Last Updated5/15/2008Contact InformationPractice LocationPractice Address106 NW 100th Ave, Plantation, FL 33324-7008Phone(954) 452-7576Fax(954) 452-8248Mailing LocationMailing Address106 NW 100th Ave, Plantation, FL 33324-7008Phone(954) 452-7576Fax(954) 452-8248Authorized OfficialNameDharmappa, Ragini (Office Manager)Phone(954) 452-7576Provider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseME0037416FloridaCode208000000XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseME0037089FloridaProvider IdentifiersIDDescriptionIssuerIDME0037089DescriptionOtherIssuerSTATE LICENSEFloridaIDME0037416DescriptionOtherIssuerST LICENSEFlorida