Organization
CHILDRENS CLINIC
Active
Parent organization
WEST FLORIDA MEDICAL ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST FLORIDA MEDICAL ASSOCIATES
Authorized official
DR. UDAY HIREMATH (OWNER)
(352) 746-3338
Entity
Organization
Contact information
Practice address
10495 N FLORIDA AVE, CITRUS SPRINGS, FL 34434-3268
(352) 746-3338
(352) 344-3414
Mailing address
10495 N FLORIDA AVE, CITRUS SPRINGS, FL 34434-3268
(352) 746-3338
(352) 344-3414
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME90418
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270242800
—
FL
Enumeration date
06/12/2012
Last updated
06/12/2012
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