# KIDS AND FAMILIES MEDICAL CLINIC LLC

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

## Provider details

- **NPI number:** 1891359998
- **Authorized official:** DR. KIA MITCHELL MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (904) 300-6248

## Contact information

- **Practice address:** 12086 FORT CAROLINE RD STE 404, JACKSONVILLE, FL 32225-7640
- **Practice address phone:** (904) 300-6248
- **Mailing address:** 12086 FORT CAROLINE RD STE 404, JACKSONVILLE, FL 32225-7640
- **Mailing address phone:** (904) 747-3800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | Yes |
| 2080P0205X | Pediatric Endocrinology Physician | — | NULL | — |
| 2080P0205X | Pediatric Endocrinology Physician | — | — | — |

## Other

- **Enumeration date:** 04/24/2019
- **Last updated:** 06/09/2020