Organization
NORTH FLORIDA PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL SANTELICES MD (PRESIDENT/CEO)
(386) 758-0003
Entity
Organization
Contact information
Practice address
5686 US HIGHWAY 129 SOUTH, SCHOOL CLINIC, JASPER, FL 32052
(386) 792-8000
(386) 755-4432
Mailing address
1859 SW NEWLAND WAY, LAKE CITY, FL 32256
(386) 758-0003
(386) 755-4432
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
FL
Other
Enumeration date
07/17/2018
Last updated
07/23/2018
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