Organization
PEDIATRIC AND INTERNAL MEDICINE SPECIALISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN MARCIA FENTON (OFFICE MANAGER)
(352) 527-6888
Entity
Organization
Contact information
Practice address
1990 N PROSPECT AVE, LECANTO, FL 34461-9792
(352) 527-6888
(352) 527-8818
Mailing address
1990 N PROSPECT AVE, LECANTO, FL 34461-9792
(352) 527-6888
(352) 527-8818
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
1396805115
FL
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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