Organization
NORTH FLORIDA PEDIATRICS PA
Active
Parent organization
NORTH FLORIDA PEDIATRICS PA.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH FLORIDA PEDIATRICS PA.
Authorized official
SAMUEL SANTELICES (PRESIDENT/CEO)
(386) 758-0003
Entity
Organization
Contact information
Practice address
2220 NORTH YOUNG BLVD, CHIEFLAND, FL 32626
(352) 221-7337
(352) 221-7344
Mailing address
1859 SW NEWLAND WAY, LAKE CITY, FL 32025
(386) 758-0003
(386) 755-4432
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101707000
—
FL
Enumeration date
09/09/2021
Last updated
09/09/2021
Update your record
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