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Organization
PEDIATRIC ASSOCIATES PA
Active
Organization
PEDIATRIC ASSOCIATES PA
Active
Parent organization
PEDIATRIC ASSOCIATES PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC ASSOCIATES PA
Authorized official
SHANNON DYER (CEO)
(850) 478-1104
Entity
Organization
Contact information
Practice address
12385 SORRENTO RD, SUITE C4, PENSACOLA, FL 32507-8664
(850) 478-1100
(850) 478-4289
Mailing address
12385 SORRENTO RD, PENSACOLA, FL 32507-8664
(850) 492-0257
(850) 492-8999
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
NULL
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Enumeration date
03/19/2013
Last updated
03/20/2013
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