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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 MD. (PRESIDENT / CEO)
(386) 758-0003
Entity
Organization

Contact information

Practice address
149 NE. 241ST STREET, STE A, CROSS CITY, FL 32628
(352) 498-3337
(352) 498-3773
Mailing address
NORTH FLORIDA PEDIATRICS, PA, 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
019432301
FL
Enumeration date
09/09/2021
Last updated
09/09/2021
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