Organization
FIRST COAST PEDIATRIC INFECTIOUS DISEASE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEBASTIAN R STANCIU MD (OWNER)
(904) 398-5614
Entity
Organization
Contact information
Practice address
1555 KINGSLEY AVE, STE. 201, ORANGE PARK, FL 32073-4560
(904) 398-5614
(904) 398-5617
Mailing address
1555 KINGSLEY AVE, STE. 201, ORANGE PARK, FL 32073-4560
(904) 398-5614
(904) 398-5617
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
ME89939
FL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
ME89939
FL
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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