Organization · Type 2 NPI

Manor Plaza Pediatric & General Medicine Inc.

Pediatrics Physician · Fort Lauderdale, FL

NPI number 1558657130 Active

Practice location

1234 NE 4th Ave Suite A
Fort Lauderdale, FL 33304-1925

Call (954) 779-1667 Map

Fax (954) 760-7253

Mailing address

1234 NE 4th Ave Ste A
Fort Lauderdale, FL 33304-1977

Specialties and licenses

Taxonomy	Code	License
Pediatrics Physician Primary	208000000X	ME0042195 (FL)
General Practice Physician	208D00000X	ME0042195 (FL)

Pediatrics Physician: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on de…

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NPI record

NPI: 1558657130
Entity type: Organization (Type 2)
Issued: Jun 22, 2011
Last updated: Mar 6, 2026
Status: Active

Other names

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Manor Plaza Pediatric and General Medicine · doing business as
Minor Plaza Pediatric and General Medicine · doing business as

Authorized official

Mrs. Helena M Gaviria, MD
Medical Director
(954) 779-1667

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1558657130

Manor Plaza Pediatric & General Medicine Inc.'s National Provider Identifier is 1558657130, issued on Jun 22, 2011. The primary taxonomy on file is Pediatrics Physician (208000000X), and the practice location is in Fort Lauderdale, FL. The record was last updated on Mar 6, 2026.