Organization
FUNCOAST PEDIATRICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES GRADY WHITE M.D. (PRESIDENT)
(386) 677-3530
Entity
Organization
Contact information
Practice address
1688 W GRANADA BLVD, SUITE 2B, ORMOND BEACH, FL 32174
(386) 677-3530
(386) 673-1933
Mailing address
1688 W GRANADA BLVD, SUITE 2B, ORMOND BEACH, FL 32174
(386) 677-3530
(386) 673-1933
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/22/2006
Last updated
08/22/2020
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