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Organization
KIDS AND FAMILIES MEDICAL CLINIC LLC
Active
Organization
KIDS AND FAMILIES MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIA MITCHELL MD (AUTHORIZED OFFICIAL)
(904) 300-6248
Entity
Organization
Contact information
Practice address
12086 FORT CAROLINE RD STE 404, JACKSONVILLE, FL 32225-7640
(904) 300-6248
Mailing address
12086 FORT CAROLINE RD STE 404, JACKSONVILLE, FL 32225-7640
(904) 747-3800
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
—
NULL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
—
—
2080P0205X
Pediatric Endocrinology Physician
—
NULL
2080P0205X
Pediatric Endocrinology Physician
—
—
Other
Enumeration date
04/24/2019
Last updated
06/09/2020
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