Organization
PEDIATRIX MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS E. GLASER (ASSISTANT SECRETARY)
(954) 384-0175
Entity
Organization
Contact information
Practice address
7101 JAHNKE RD, RICHMOND, VA 23225-4017
(804) 323-8893
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
0024102823
VA
Other
Enumeration date
04/20/2009
Last updated
11/04/2024
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