Organization
FOUNTAIN PEDIATRICS, INC
Active
Organization
FOUNTAIN PEDIATRICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARA LEE MIHELICH MS, OTR/L (OWNER/DIRECTOR)
(813) 850-4816
Entity
Organization
Contact information
Practice address
9814 49TH AVE N, ST PETERSBURG, FL 33708-3634
(813) 850-4816
Mailing address
9814 49TH AVE N, ST PETERSBURG, FL 33708-3634
(813) 850-4816
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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