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Organization

FLORIDA PEDIATRIC GROUP PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEE DEE SCHULTZ (BILLING DEPARTMENT)
(321) 752-5210
Entity
Organization

Contact information

Practice address
250 S WICKHAM RD, W MELBOURNE, FL 32904-1134
(321) 752-5210
(321) 752-5388
Mailing address
250 S WICKHAM RD, W MELBOURNE, FL 32904-1134
(321) 752-5210
(321) 752-5388

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME81059
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
259807800
FL
Enumeration date
04/19/2007
Last updated
02/20/2025
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