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Organization
KIDS CARE PEDIATRICS,PA
Active
Organization
KIDS CARE PEDIATRICS,PA
Active
Other names
Kids Care Pediatrics Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN MARK ROSENBERG (PRACTICE ADVISOR)
(386) 328-7337
Entity
Organization
Contact information
Practice address
6910 OLD WOLF BAY RD, PALATKA, FL 32177-6800
(386) 328-7337
(386) 325-3742
Mailing address
6910 OLD WOLF BAY RD, PALATKA, FL 32177-6800
(386) 328-7337
(386) 325-3742
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/01/2006
Last updated
03/15/2021
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