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
2220 NORTH YOUNG BLVD, CHIEFLAND, FL 32626
(352) 221-7337
(352) 221-7344
Mailing address
1859 SW NEWLAND WAY, LAKE CITY, FL 32025
(386) 758-0003
(386) 755-4432
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101707000
—
FL
Enumeration date
10/09/2017
Last updated
09/08/2021
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