Organization
CHILDREN'S EXPRESS CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUWARNA M TILAK MD (PRESIDENT)
(904) 519-0008
Entity
Organization
Contact information
Practice address
430 COLLEGE DR UNIT 100-102, MIDDLEBURG, FL 32068-8530
(904) 644-8669
Mailing address
10175 FORTUNE PKWY UNIT 402, JACKSONVILLE, FL 32256-6750
(904) 519-0008
(904) 379-7312
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
604727
FL
Other
Enumeration date
01/05/2012
Last updated
07/21/2022
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