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Organization

AGES & STAGES PEDIATRICS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADRIANA ROSADO-JIMENEZ MD (CEO)
(980) 498-3900
Entity
Organization

Contact information

Practice address
10340 PARK RD STE B, CHARLOTTE, NC 28210-8401
(980) 498-3900
Mailing address
10340 PARK RD STE B, CHARLOTTE, NC 28210-8401
(980) 498-3900

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1811392343
NPI
Enumeration date
12/17/2018
Last updated
06/10/2019
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