Organization
PEDIATRIC ASSOCIATES OF NE FLORIDA, LLC
Active
Parent organization
PEDIATRIC ASSOCIATES HOLDING COMPANY
Other names
Jacksonville Pediatric Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC ASSOCIATES HOLDING COMPANY
Authorized official
PATRICIA CORSIATTO (DIRECTOR)
(954) 967-6400
Entity
Organization
Contact information
Practice address
1951 BOULEVARD, JACKSONVILLE, FL 32206-3527
(904) 354-6868
(904) 358-3067
Mailing address
900 S PINE ISLAND RD, 800, PLANTATION, FL 33324-3920
(954) 967-6400
(954) 965-7339
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011962601
—
FL
Enumeration date
04/24/2014
Last updated
08/25/2020
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