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
Update your record
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