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Organization
NORTH FLORIDA PEDIATRICS, PA.
Active
Organization
NORTH FLORIDA PEDIATRICS, PA.
Active
Parent organization
NORTH FLORIDA PEDIATRICS, P.A
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH FLORIDA PEDIATRICS, P.A
Authorized official
SAMUEL SANTELICES MD. (PRESIDENT/ CEO)
(386) 758-0003
Entity
Organization
Contact information
Practice address
NORTH FLORIDA PEDIATRICS PA ., 1859 SW NEWLAND WAY, LAKE CITY, FL 32025
(386) 758-0003
(386) 755-4432
Mailing address
1859 SW NEWLAND WAY, LAKE CITY, FL 32025-6966
(386) 758-0003
(386) 755-4432
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME87551
FL
2080A0000X
Pediatric Adolescent Medicine Physician
ME87551
FL
261QR1300X
Rural Health Clinic/Center
Primary
ME87551
FL
Other
Enumeration date
06/14/2005
Last updated
09/08/2021
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