# KIDS CARE PEDIATRICS,PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kids Care Pediatrics Rural Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518044528
- **Authorized official:** OWEN MARK ROSENBERG (PRACTICE ADVISOR)
- **Authorized official phone:** (386) 328-7337

## Contact information

- **Practice address:** 6910 OLD WOLF BAY RD, PALATKA, FL 32177-6800
- **Practice address phone:** (386) 328-7337
- **Practice address fax:** (386) 325-3742
- **Mailing address:** 6910 OLD WOLF BAY RD, PALATKA, FL 32177-6800
- **Mailing address phone:** (386) 328-7337
- **Mailing address fax:** (386) 325-3742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 03/15/2021