Organization
LITTLE PINE PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY STROUD (PRACTICE MANAGER)
(855) 577-5437
Entity
Organization
Contact information
Practice address
15551 NW US HIGHWAY 441 UNIT 40, ALACHUA, FL 32615-9330
(386) 518-0102
Mailing address
1702 S JEFFERSON ST, PERRY, FL 32348-5611
(855) 577-5437
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001165806
—
FL
Enumeration date
07/27/2021
Last updated
10/06/2021
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