Organization
PEDIATRIC INNOVATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHRAF AFFAN M.D. (PRESIDENT)
(904) 616-2772
Entity
Organization
Contact information
Practice address
13241 BARTRAM PARK BLVD, SUITE 209, JACKSONVILLE, FL 32258-5212
(904) 616-2772
(904) 674-2313
Mailing address
13241 BARTRAM PARK BLVD, SUITE 209, JACKSONVILLE, FL 32258-5212
(904) 616-2772
(904) 674-2313
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME86016
FL
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
Update your record
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