# LITTLE PINE PEDIATRICS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053084913
- **Authorized official:** KIMBERLY STROUD (PRACTICE MANAGER)
- **Authorized official phone:** (855) 577-5437

## Contact information

- **Practice address:** 15551 NW US HIGHWAY 441 UNIT 40, ALACHUA, FL 32615-9330
- **Practice address phone:** (386) 518-0102
- **Mailing address:** 1702 S JEFFERSON ST, PERRY, FL 32348-5611
- **Mailing address phone:** (855) 577-5437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2021
- **Last updated:** 10/06/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001165806 | — | FL |