Organization
FLORIDA CLINICAL PRACTICE ASSOCIATION INC
Active
Other names
UF Health Pediatrics - Magnolia Parke
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY SIBISKI (EXECUTIVE VICE PRESIDENT)
(352) 265-8017
Entity
Organization
Contact information
Practice address
4740 NW 39TH PL, STE B, GAINESVILLE, FL 32606-7226
(352) 594-7337
(352) 265-5343
Mailing address
PO BOX 13833, PHILADELPHIA, PA 19101-3833
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053386643
—
FL
Enumeration date
06/10/2013
Last updated
11/24/2020
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