Organization
KIDS CARE PEDIATRICS,PA
Active
Other names
Kids Care Pediatrics Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN MARK ROSENBERG (PRACTICE ADVISOR)
(386) 328-7337
Entity
Organization
Contact information
Practice address
6910 OLD WOLF BAY RD, PALATKA, FL 32177-6800
(386) 328-7337
(386) 325-3742
Mailing address
6910 OLD WOLF BAY RD, PALATKA, FL 32177-6800
(386) 328-7337
(386) 325-3742
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107889600
—
FL
Enumeration date
11/01/2006
Last updated
03/15/2021
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