Organization
ADOLESCENT AND PEDIATRIC MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIONEL HENRY M.D. (OWNER/DOCTOR)
(850) 878-5147
Entity
Organization
Contact information
Practice address
1638 N PLAZA DR, TALLAHASSEE, FL 32308-5323
(850) 878-5147
(850) 942-9844
Mailing address
1638 N PLAZA DR, TALLAHASSEE, FL 32308-5323
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ME39184
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066082500
—
FL
Enumeration date
03/26/2010
Last updated
03/26/2010
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