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
NORTH FLORIDA PEDIATRICS, PA, 1101 OHIO AVENUE SOUTH, LIVE OAK, FL 32064
(386) 339-1060
(386) 339-1067
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
—
015048101
—
FL
Enumeration date
09/15/2021
Last updated
09/15/2021
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