Organization
DOCTORS INLET PEDIATRICS & PRIMARY CARE, PA
Active
Parent organization
DOCTORS INLET PEDIATRICS AND PRIMARY CARE, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOCTORS INLET PEDIATRICS AND PRIMARY CARE, PA
Authorized official
MILIND V TILAK MD (OWNER)
(904) 298-1994
Entity
Organization
Contact information
Practice address
10175 FORTUNE PKWY UNIT 401, JACKSONVILLE, FL 32256
(904) 298-1994
(904) 298-1973
Mailing address
10175 FORTUNE PKWY UNIT 401, JACKSONVILLE, FL 32256-6750
(904) 298-1994
(904) 298-1973
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265248001
—
FL
Enumeration date
06/06/2007
Last updated
07/21/2022
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