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Organization
NORTH FLORIDA PEDIATRICS, PA
Active
Organization
NORTH FLORIDA PEDIATRICS, PA
Active
Parent organization
NORTH FLORIDA PEDIATRICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH FLORIDA PEDIATRICS
Authorized official
SAMUEL SANTELICES MD (PRESIDENT/CEO)
(386) 758-0003
Entity
Organization
Contact information
Practice address
NORTH FLORIDA PEDIATRICS, PA, 1117 NW HWY 41 STE B, JASPER, FL 32052
(386) 792-3864
(386) 792-1530
Mailing address
1859 SW NEWLAND WAY, LAKE CITY, FL 32025
(386) 758-0003
(386) 755-4432
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME87551
FL
261QR1300X
Rural Health Clinic/Center
Primary
ME87551
FL
Other
Enumeration date
06/15/2005
Last updated
09/08/2021
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