Organization
GAINESVILLE PEDIATRIC MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE NUMSSEN MD (PRESIDENT)
(352) 332-9940
Entity
Organization
Contact information
Practice address
1131 NW 64 TERRACE, SUITE B, GAINESVILLE, FL 32605-6600
(352) 332-9940
(352) 332-9939
Mailing address
1131 NW 64 TERRACE, SUITE B, GAINESVILLE, FL 32605-6600
(352) 332-9940
(352) 332-9939
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME78807
FL
208000000X
Pediatrics Physician
ME79357
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032025100
—
FL
05
—
032026900
—
FL
01
—
2680
BCBS
FL
Enumeration date
12/08/2008
Last updated
12/19/2008
Update your record
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