# PEDIATRIC RHEUMATOLOGY ASSOCIATES LLC

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

## Provider details

- **NPI number:** 1467085902
- **Authorized official:** MR. ADAM KUETTEL (CEO)
- **Authorized official phone:** (850) 262-8645

## Contact information

- **Practice address:** 12591 SORRENTO RD STE A, PENSACOLA, FL 32507-8754
- **Practice address phone:** (850) 262-8645
- **Practice address fax:** (850) 262-8647
- **Mailing address:** 29939 ONO BLVD, ORANGE BEACH, AL 36561-3634
- **Mailing address phone:** (501) 231-4367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | — |

## Other

- **Enumeration date:** 02/12/2020
- **Last updated:** 10/07/2020