Organization
HERAUD PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIEGO HERAUD (OWNER)
(314) 813-3750
Entity
Organization
Contact information
Practice address
1120 CARLTON AVE STE 1300, LAKE WALES, FL 33853-4347
(863) 676-6386
Mailing address
9719 CAMBERLEY CIR, ORLANDO, FL 32836-5746
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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