# ADOLESCENT AND PEDIATRIC MEDICAL CENTER

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

## Provider details

- **NPI number:** 1093039562
- **Authorized official:** DR. LIONEL HENRY M.D. (OWNER/DOCTOR)
- **Authorized official phone:** (850) 878-5147

## Contact information

- **Practice address:** 1638 N PLAZA DR, TALLAHASSEE, FL 32308-5323
- **Practice address phone:** (850) 878-5147
- **Practice address fax:** (850) 942-9844
- **Mailing address:** 1638 N PLAZA DR, TALLAHASSEE, FL 32308-5323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | ME39184 | FL | Yes |

## Other

- **Enumeration date:** 03/26/2010
- **Last updated:** 03/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 066082500 | — | FL |