Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Manor Plaza Pediatric & General Medicine Inc

Organization Pediatrics Physician · NPI 1558657130

Manor Plaza Pediatric & General Medicine Inc is a Pediatrics Physician in Fort Lauderdale, Florida. Licensed in Florida. Registered with an NPI since 2011.

Licensed in
FL
In the registry since
2011
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1234 NE 4th Ave Ste A
Fort Lauderdale, FL 33304-1925
Phone: (954) 779-1667
Fax: (954) 760-7253
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence ME0042195 (FL)
General Practice Physician Taxonomy 208D00000X · Licence ME0042195 (FL)

Record details

NPI number1558657130
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Helena Gaviria — Medical Director · (954) 779-1667
Other names Manor Plaza Pediatric And General Medicine; Minor Plaza Pediatric And General Medicine
NPI enumeratedJune 22, 2011
Last updated in NPPESMarch 6, 2026
Certification dateMarch 6, 2026
Mailing address1234 Ne 4th Ave Ste A, Fort Lauderdale, FL 33304-1977

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