Organization
ABC PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LELA JOHNSON (OFFICE MANAGER)
(850) 689-0900
Entity
Organization
Contact information
Practice address
1005 COLLEGE BLVD W, SUITE B, NICEVILLE, FL 32578-1053
(850) 689-0900
Mailing address
1005 COLLEGE BLVD W, SUITE B, NICEVILLE, FL 32578-1053
(850) 689-0900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME56157
FL
Other
Enumeration date
07/14/2006
Last updated
10/11/2007
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