# PM PEDIATRICS

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

## Provider details

- **NPI number:** 1356779250
- **Authorized official:** DR. MICHELE JOHNSON M.D. (OWNER/MD)
- **Authorized official phone:** (813) 264-2288

## Contact information

- **Practice address:** 1338 W FLETCHER AVE, TAMPA, FL 33612-3366
- **Practice address phone:** (813) 264-2288
- **Practice address fax:** (813) 264-1677
- **Mailing address:** 1338 W FLETCHER AVE, TAMPA, FL 33612-3366
- **Mailing address phone:** (813) 264-2288
- **Mailing address fax:** (813) 264-1677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | ME62751 | FL | Yes |

## Other

- **Enumeration date:** 10/31/2013
- **Last updated:** 10/29/2015