Organization
PEDIATRIC CENTER FOR EXCELLENCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHRAF A AFFAN MD (OWNER)
(904) 224-5437
Entity
Organization
Contact information
Practice address
13241 BARTRAM PARK BLVD UNIT 209, JACKSONVILLE, FL 32258-5233
(904) 224-5437
(904) 674-2313
Mailing address
13241 BARTRAM PARK BLVD UNIT 209, JACKSONVILLE, FL 32258-5233
(904) 224-5437
(904) 674-2313
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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