Organization
PEDIATRICS PLUS
Active
Organization
PEDIATRICS PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA NELSON (OWNER PRESIDENT)
(850) 769-5371
Entity
Organization
Contact information
Practice address
927 GRACE AVE, PANAMA CITY, FL 32401-2521
(850) 769-5371
(850) 872-9558
Mailing address
927 GRACE AVE, PANAMA CITY, FL 32401-2521
(850) 769-5371
(850) 872-9558
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT22753
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001086000
—
FL
Enumeration date
05/17/2011
Last updated
05/17/2011
Update your record
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