Organization
INDIAN RIVER PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY R SMITH (PRACTICE MANAGER)
(772) 978-9000
Entity
Organization
Contact information
Practice address
840 37TH PL STE 1N, VERO BEACH, FL 32960-6502
(772) 978-9000
(772) 978-9922
Mailing address
840 37TH PL STE 1N, VERO BEACH, FL 32960-6502
(772) 978-9000
(772) 978-9922
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME78173
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256588900
—
FL
Enumeration date
10/07/2014
Last updated
10/07/2014
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