Organization
NORTH FLORIDA PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL SANTELICES M.D. (PRESIDENT/CEO)
(386) 758-0003
Entity
Organization
Contact information
Practice address
145 HILDEN ROAD SUITE 101, PONTE VEDRA, FL 32081
(904) 393-4700
(904) 493-9700
Mailing address
1859 SW NEWLAND WAY, LAKE CITY, FL 32025
(386) 758-0003
(386) 755-4432
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
09/03/2019
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