Organization
FLORIDA PEDIATRIC GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAGED FARID (CEO)
(321) 752-5210
Entity
Organization
Contact information
Practice address
250 S WICKHAM RD, WEST MELBOURNE, FL 32904-1134
(321) 752-5210
Mailing address
250 S WICKHAM RD, WEST MELBOURNE, FL 32904-1134
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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