Organization
NORTH FLORIDA PEDIATRICS, PA
Active
Parent organization
NORTH FLORIDA PEDIATRICS PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH FLORIDA PEDIATRICS PA
Authorized official
DR. SAMUEL SANTELICES MD (PRESIDENT/CEO)
(386) 758-0003
Entity
Organization
Contact information
Practice address
149 NE. 241ST STREET STE A, CROSS CITY, FL 32628
(352) 498-3337
(352) 498-3773
Mailing address
1859 SW NEWLAND WAY, LAKE CITY, FL 32025
(386) 758-0003
(386) 755-4432
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019432300
—
FL
Enumeration date
09/15/2015
Last updated
09/09/2021
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