Organization
BLUE SPRIG PEDIATRICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARKALISE MITCHELL (CRED SPECIALIST)
(281) 541-8674
Entity
Organization
Contact information
Practice address
4170 N 108TH AVE, PHOENIX, AZ 85037-5469
(480) 751-1957
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(833) 288-4761
(346) 261-0052
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/20/2022
Last updated
03/03/2026
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