Organization
PATHWAY PEDIATRIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASPEN NEACE (AR)
(386) 316-3904
Entity
Organization
Contact information
Practice address
137 S LAKE GEORGE DR, GEORGETOWN, FL 32139-3109
(386) 316-3904
Mailing address
137 S LAKE GEORGE DR, GEORGETOWN, FL 32139-3109
(386) 316-3904
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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