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Organization
PEDIATRIC RHEUMATOLOGY ASSOCIATES LLC
Active
Organization
PEDIATRIC RHEUMATOLOGY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM KUETTEL (CEO)
(850) 262-8645
Entity
Organization
Contact information
Practice address
12591 SORRENTO RD STE A, PENSACOLA, FL 32507-8754
(850) 262-8645
(850) 262-8647
Mailing address
29939 ONO BLVD, ORANGE BEACH, AL 36561-3634
(501) 231-4367
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
NULL
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
291U00000X
Clinical Medical Laboratory
—
NULL
332900000X
Non-Pharmacy Dispensing Site
—
NULL
Other
Enumeration date
02/12/2020
Last updated
10/07/2020
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